Individual
HOLLY DIANE PENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2499
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209.020805
IL
363LF0000X
Family Nurse Practitioner
Primary
277001909
IL
Other
Enumeration date
02/06/2020
Last updated
03/02/2026
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