Healthcare Provider Details

I. General information

NPI: 1710134895
Provider Name (Legal Business Name): PENNY CAROL LOGAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9057 MANCHESTER HWY
MORRISON TN
37357-5911
US

IV. Provider business mailing address

PO BOX 227
ALBANY KY
42602-0227
US

V. Phone/Fax

Practice location:
  • Phone: 606-306-7706
  • Fax: 606-777-7560
Mailing address:
  • Phone: 606-306-7706
  • Fax: 606-777-7560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5684P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: