Provider Demographics
NPI:1063506525
Name:WHITING, PENNEY P (LPN)
Entity Type:Individual
Prefix:
First Name:PENNEY
Middle Name:P
Last Name:WHITING
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 OLD REED CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HARTWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30643
Mailing Address - Country:US
Mailing Address - Phone:706-376-2946
Mailing Address - Fax:
Practice Address - Street 1:287 OLD REED CREEK RD
Practice Address - Street 2:
Practice Address - City:HARTWELL
Practice Address - State:GA
Practice Address - Zip Code:30643
Practice Address - Country:US
Practice Address - Phone:706-376-2946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN037855164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse