Provider Demographics
NPI:1093173924
Name:PENNYBAKER, ASHLEY (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:PENNYBAKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 COMMERCE ST FL 7
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1826
Mailing Address - Country:US
Mailing Address - Phone:844-326-3119
Mailing Address - Fax:
Practice Address - Street 1:333 COMMERCE ST FL 7
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37201-1826
Practice Address - Country:US
Practice Address - Phone:844-326-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-06
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.18712-NP261QP2300X
OH18712363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care