Individual
ALLYSON MARIE PENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1160 E LAKESHORE DR, CARRIERE, MS 39426-7716
(601) 622-2423
Mailing address
1160 E LAKESHORE DR, CARRIERE, MS 39426-7716
(601) 622-2423
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
885758
MS
363LF0000X
Family Nurse Practitioner
Primary
885758
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00537363
—
MS
Enumeration date
07/06/2018
Last updated
06/07/2022
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