Provider Demographics
NPI:1184810830
Name:WESSON, PENNY ANN (MD)
Entity type:Individual
Prefix:DR
First Name:PENNY
Middle Name:ANN
Last Name:WESSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N34W28453 TAYLORS WOODS RD
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-3365
Mailing Address - Country:US
Mailing Address - Phone:262-691-3430
Mailing Address - Fax:
Practice Address - Street 1:N34W28453 TAYLORS WOODS RD
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-3365
Practice Address - Country:US
Practice Address - Phone:262-691-3430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46894020207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology