Provider Demographics
NPI:1992226153
Name:DANZIGER, PENINA (FNP-C)
Entity type:Individual
Prefix:
First Name:PENINA
Middle Name:
Last Name:DANZIGER
Suffix:
Gender:F
Credentials: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:P O BOX 1000 DEPT 978
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-373-7100
Mailing Address - Fax:901-842-0020
Practice Address - Street 1:6570 SUMMER OAKS CV
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134
Practice Address - Country:US
Practice Address - Phone:901-373-7100
Practice Address - Fax:901-842-0020
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24366363LF0000X
NY341942363LP2300X
NJ26NJ00656200363LP2300X
NC5019611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care