Individual
KAREN R PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
921 GREELEY ST S, STILLWATER, MN 55082
(651) 439-1234
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 439-1234
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10413
MN
363A00000X
Physician Assistant
1242
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42995400
—
WI
Enumeration date
08/31/2006
Last updated
02/25/2020
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