Provider Demographics
NPI:1588045231
Name:PENNINGTON, LEEANN (RN)
Entity type:Individual
Prefix:
First Name:LEEANN
Middle Name:
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 COUNTY ROAD 219
Mailing Address - Street 2:
Mailing Address - City:MARENGO
Mailing Address - State:OH
Mailing Address - Zip Code:43334-9465
Mailing Address - Country:US
Mailing Address - Phone:740-815-6169
Mailing Address - Fax:
Practice Address - Street 1:536 WILLIS LN
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1138
Practice Address - Country:US
Practice Address - Phone:740-513-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN149354-M-IV164W00000X
OHRN.438009163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse