Individual
MRS. JACLYN ANNETTE PENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 988-0000
Mailing address
632 COLORADO AVE SW, ORANGE CITY, IA 51041-1945
(802) 579-4952
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA065062
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/06/2022
Last updated
03/14/2024
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