Provider Demographics
NPI:1477987659
Name:PENNINGTON, EMILY (LPN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:CROOKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43731-1346
Mailing Address - Country:US
Mailing Address - Phone:740-704-4908
Mailing Address - Fax:
Practice Address - Street 1:309 WINTER ST
Practice Address - Street 2:
Practice Address - City:CROOKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43731-1346
Practice Address - Country:US
Practice Address - Phone:740-704-4908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-24
Last Update Date:2013-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH127406164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse