Individual
MS. JOAHNE C PENNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6005A WEST NORTH AVENUE, WAUWATOSA, WI 53213
(414) 258-1228
Mailing address
POB 274, OAK CREEK, WI 53154-0274
(847) 489-1100
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303939-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35066200
—
WI
Enumeration date
03/02/2010
Last updated
03/02/2010
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