Individual
MS. DONNA A PENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2101 E JEFFERSON ST, ROCKVILLE, MD 20853
(301) 816-2414
(301) 388-1740
Mailing address
KAISER PERMANENTE MID ATLANTIC PERMANENTE MED GRP PC, 2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W, ROCKVILLE, MD 20852
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0001042360
VA
363L00000X
Nurse Practitioner
Primary
0024042360
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
218487ZDCT
MEDICARE ID TYPE UNSPECIFIED
—
Enumeration date
11/28/2006
Last updated
01/05/2012
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