Provider Demographics
NPI:1295747970
Name:PARLER, PENNI EUGINA (MS, CRNP)
Entity type:Individual
Prefix:MRS
First Name:PENNI
Middle Name:EUGINA
Last Name:PARLER
Suffix:
Gender:F
Credentials:MS, CRNP
Other - Prefix:
Other - First Name:PENNI
Other - Middle Name:EUGINA
Other - Last Name:FARENICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CRNP
Mailing Address - Street 1:8821 COLUMBIA 100 PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2168
Mailing Address - Country:US
Mailing Address - Phone:410-997-1700
Mailing Address - Fax:410-740-8315
Practice Address - Street 1:8821 COLUMBIA 100 PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2168
Practice Address - Country:US
Practice Address - Phone:410-997-1700
Practice Address - Fax:410-740-8315
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR119137363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics