Provider Demographics
NPI:1659984771
Name:PENNINGTON, AMY (APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 HIGHWAY 305 SOUTH- B1200
Mailing Address - Street 2:
Mailing Address - City:MCCAMEY
Mailing Address - State:TX
Mailing Address - Zip Code:79752
Mailing Address - Country:US
Mailing Address - Phone:432-652-4010
Mailing Address - Fax:432-652-4013
Practice Address - Street 1:2500 HIGHWAY 305 SOUTH
Practice Address - Street 2:
Practice Address - City:MCCAMEY
Practice Address - State:TX
Practice Address - Zip Code:79752-1200
Practice Address - Country:US
Practice Address - Phone:432-652-4010
Practice Address - Fax:432-652-4013
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000178363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily