Individual
MRS. VICTORIA CHANNELL PENEBAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3200 VINE ST, CINCINNATI, OH 45220-2213
(513) 475-6368
(513) 475-6411
Mailing address
3220 VINE STREET, CINCINNATI, OH 45220
(513) 475-6368
(513) 475-6411
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN 138011
OH
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
RN138011-COA1
OH
Other
Enumeration date
10/13/2006
Last updated
04/23/2015
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