Provider Demographics
NPI:1770387136
Name:KINDER, PENNY
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:
Last Name:KINDER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 RESTON LN
Mailing Address - Street 2:
Mailing Address - City:RIDGEVIEW
Mailing Address - State:WV
Mailing Address - Zip Code:25169-9291
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:199 RESTON LN
Practice Address - Street 2:
Practice Address - City:RIDGEVIEW
Practice Address - State:WV
Practice Address - Zip Code:25169-9291
Practice Address - Country:US
Practice Address - Phone:304-951-4871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide