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Individual

MS. MISTY MARIE PENROD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
3 PROGRESSIVE ST, BLUFFTON, SC 29910-5165
(843) 548-0533
(843) 815-9121
Mailing address
1053 CENTER STREET, SC HOUSE CALLS INC, WEST COLUMBIA, SC 29169-1873
(800) 491-0909

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23137
SC
363LF0000X
Family Nurse Practitioner
RN.251801-COA1
OH
363LP0200X
Pediatric Nurse Practitioner
251801
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0091989
OH
05
NP6344
SC
Enumeration date
07/11/2012
Last updated
02/20/2023
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