Individual
LISA PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2420 ARGILLITE RD STE B, FLATWOODS, KY 41139-1972
(606) 836-3900
Mailing address
PO BOX 1595, ASHLAND, KY 41105-1595
(606) 836-3900
(606) 836-0205
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA303
KY
363AM0700X
Medical Physician Assistant
Primary
PA303
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95003166
—
KY
Enumeration date
11/09/2005
Last updated
05/23/2022
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