Provider Demographics
NPI:1295035939
Name:PENNEY, LINDA J
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:PENNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 THOMAS DR
Mailing Address - Street 2:APARTMENT 6
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-7716
Mailing Address - Country:US
Mailing Address - Phone:717-761-0930
Mailing Address - Fax:717-761-0465
Practice Address - Street 1:423 N 21ST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2207
Practice Address - Country:US
Practice Address - Phone:717-761-0930
Practice Address - Fax:717-761-0465
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN261858164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse