Provider Demographics
NPI:1467257360
Name:PENNINGTON, ANGELETA LYN (LPN)
Entity type:Individual
Prefix:
First Name:ANGELETA
Middle Name:LYN
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-2103
Mailing Address - Country:US
Mailing Address - Phone:816-922-2160
Mailing Address - Fax:816-922-4843
Practice Address - Street 1:501 S HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-2103
Practice Address - Country:US
Practice Address - Phone:816-922-2160
Practice Address - Fax:816-922-4843
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23-21925-081164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse