Individual
MS. TERRY LYNN PENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS ANP-C ACNP-BC
Contact information
Practice address
3514 N POWER RD STE 127, MESA, AZ 85215-2911
(480) 571-8460
(480) 571-8461
Mailing address
3514 N POWER RD STE 127, MESA, AZ 85215-2911
(480) 571-8460
(480) 571-8461
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
AP-1086
AZ
363LA2200X
Adult Health Nurse Practitioner
Primary
AP-1086
AZ
363LA2200X
Adult Health Nurse Practitioner
RN066900
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
584947
—
AZ
Enumeration date
12/31/2005
Last updated
04/13/2019
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