Individual
MS. MICHELE R PENNYWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
895 S MARKS AVE, FRESNO, CA 93706-2200
(559) 777-0435
(559) 412-8119
Mailing address
PO BOX 1375, FRESNO, CA 93716-1375
(559) 777-0435
(559) 412-8119
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
700492
CA
163WC0400X
Case Management Registered Nurse
Primary
700492
CA
163WC1500X
Community Health Registered Nurse
700492
CA
163WG0000X
General Practice Registered Nurse
700492
CA
163WH0200X
Home Health Registered Nurse
700492
CA
163WM0705X
Medical-Surgical Registered Nurse
700492
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
700492
CA
163WR0400X
Rehabilitation Registered Nurse
700492
CA
Other
Enumeration date
01/24/2008
Last updated
04/02/2012
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