Provider Demographics
NPI:1598737686
Name:UTHE, PENNIE LEA (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:PENNIE
Middle Name:LEA
Last Name:UTHE
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
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Mailing Address - Street 1:909 ARTESIA WAY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6746
Mailing Address - Country:US
Mailing Address - Phone:757-721-4197
Mailing Address - Fax:
Practice Address - Street 1:1550 TOMCAT BLVD
Practice Address - Street 2:BMC OCEANA--FP, NAS OCEANA
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23460-2218
Practice Address - Country:US
Practice Address - Phone:757-314-7174
Practice Address - Fax:757-314-7124
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical