Individual
MRS. PENNY LYNN VINNEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449
(715) 387-9220
Mailing address
1000 N OAK AVE, 3F1, MARSHFIELD, WI 54449-5777
(715) 387-5321
(715) 389-3336
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1724
WI
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41988200
—
WI
Enumeration date
09/11/2006
Last updated
12/12/2020
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