Provider Demographics
NPI:1477332161
Name:PELKEY, PENNY LEA (PRSS)
Entity Type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:LEA
Last Name:PELKEY
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:MRS
Other - First Name:PENNY
Other - Middle Name:LEA
Other - Last Name:PELKEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PRSS
Mailing Address - Street 1:207 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-8744
Mailing Address - Country:US
Mailing Address - Phone:405-834-8251
Mailing Address - Fax:
Practice Address - Street 1:909 ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5229
Practice Address - Country:US
Practice Address - Phone:405-360-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist