Individual
MRS. PENNI LANE EXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
424 N LOCUST ST, MOMENCE, IL 60954-1236
(219) 973-8716
Mailing address
424 N LOCUST ST, MOMENCE, IL 60954-1236
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
04148062
IL
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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