Individual
MRS. DONNA S PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1535 GULL RD, # 150, KALAMAZOO, MI 49048-1650
(269) 488-2191
(269) 488-2191
Mailing address
1535 GULL RD, SUITE 150, KALAMAZOO, MI 49048-1650
(269) 488-2191
(269) 488-2191
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704135201
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704135201
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5008704510
BCBS PIN
MI
Enumeration date
06/21/2006
Last updated
10/16/2014
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