Individual
LAURA V PENNONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-4021
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1865
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704205471
MI
Other
Enumeration date
02/18/2013
Last updated
11/11/2022
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