Provider Demographics
NPI:1114658291
Name:PENNINGTON, HARLEE A (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:HARLEE
Middle Name:A
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3457
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72203-3457
Mailing Address - Country:US
Mailing Address - Phone:501-406-6180
Mailing Address - Fax:
Practice Address - Street 1:1700 E SHORT HILLSBORO ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-6458
Practice Address - Country:US
Practice Address - Phone:870-862-5124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR220754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily