Provider Demographics
NPI:1518203686
Name:LAMASCUS, PENNY NELEEN (MSN WHNP-BC / ANP)
Entity Type:Individual
Prefix:MS
First Name:PENNY
Middle Name:NELEEN
Last Name:LAMASCUS
Suffix:
Gender:F
Credentials:MSN WHNP-BC / ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1923
Mailing Address - Country:US
Mailing Address - Phone:937-322-1700
Mailing Address - Fax:937-398-5189
Practice Address - Street 1:1010 S LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-3058
Practice Address - Country:US
Practice Address - Phone:937-325-1010
Practice Address - Fax:937-325-5144
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.14126-NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health