Individual
HEATHER ANN PENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
480 OSBORNE RD NE, SUITE 220, FRIDLEY, MN 55432-2773
(763) 786-1620
(763) 780-3099
Mailing address
480 OSBORNE RD NE, SUITE 220, FRIDLEY, MN 55432-2773
(763) 786-1620
(763) 780-3099
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R 132897-2
MN
363LG0600X
Gerontology Nurse Practitioner
R 132897-2
MN
Other
Enumeration date
09/07/2007
Last updated
11/13/2015
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