Individual
BRIAN J PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8212 SUMMA AVE, BATON ROUGE, LA 70809-3421
(225) 769-4403
(225) 769-3842
Mailing address
8212 SUMMA AVE, BATON ROUGE, LA 70809-3421
(225) 769-4403
(225) 769-3842
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN106295 AP05392
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079477
CCNA
LA
Enumeration date
06/30/2008
Last updated
06/30/2008
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