Provider Demographics
NPI:1174685580
Name:FINN, PENELOPE ROSE (RN)
Entity Type:Individual
Prefix:MRS
First Name:PENELOPE
Middle Name:ROSE
Last Name:FINN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 TEHAMA AVE
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965
Mailing Address - Country:US
Mailing Address - Phone:530-532-4214
Mailing Address - Fax:
Practice Address - Street 1:5910 CLARK ROAD
Practice Address - Street 2:SUITE H & I
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969
Practice Address - Country:US
Practice Address - Phone:530-872-6325
Practice Address - Fax:530-872-5970
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN372655163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN372655OtherLICENSE NUMBER