Provider Demographics
NPI:1023421039
Name:VAYON, PENNY (FNP-C)
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:
Last Name:VAYON
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 1:113 CROWN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-8919
Mailing Address - Country:US
Mailing Address - Phone:409-728-4543
Mailing Address - Fax:
Practice Address - Street 1:18 AUDUBON PL
Practice Address - Street 2:
Practice Address - City:PORT NECHES
Practice Address - State:TX
Practice Address - Zip Code:77651-5934
Practice Address - Country:US
Practice Address - Phone:409-728-4543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125736363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily