Individual
IAISHA PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 COMMONWEALTH BLVD W, MARTINSVILLE, VA 24112-1832
(276) 666-7328
Mailing address
110 COMMONWEALTH BLVD W, MARTINSVILLE, VA 24112-1832
(276) 634-4914
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024189126
VA
Other
Enumeration date
09/27/2023
Last updated
01/04/2024
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