Provider Demographics
NPI:1346583481
Name:PENLEY, PATRICIA (FNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:PENLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JAMES H. QUILLEN-VAMC
Mailing Address - Street 2:CORNER OF SIDNEY AND LAMONT
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37684-9901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:JAMES H. QUILLEN-VAMC
Practice Address - Street 2:CORNER OF SIDNEY AND LAMONT
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37684-9901
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily