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General NPI Number Information
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NPI Number | 1003861162
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Entity Type | Individual
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Provider Name | JESSICA ABNEY PENNINGTON MD
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 2750 BATTLEFIELD MEMORIAL HWY
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City | BEREA
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State | KY
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Zip | 40403-8332
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Country | US
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Telephone | 859-986-0302
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Fax | 859-986-0315
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Provider Business Mailing Address
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Address Line | PO BOX 936
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City | LONDON
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State | KY
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Zip | 40743-0936
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 37778
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License Number State | KY
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