Individual
MRS. PAULA LYNN PENGILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
17807 US HWY 59 NE, ROSE MEDICAL MANAGEMENT, THIEF RIVER FALLS, MN 56701-5670
(361) 413-5179
Mailing address
3461 37TH ST NE, INKSTER, ND 58233-9306
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP91014
ME
Other
Enumeration date
08/30/2005
Last updated
12/04/2020
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