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General NPI Number Information
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NPI Number | 1023421039
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Entity Type | Individual
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Provider Name | PENNY VAYON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/06/2014
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 18 AUDUBON PL
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City | PORT NECHES
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State | TX
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Zip | 77651-5934
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Country | US
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Telephone | 409-728-4543
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Fax |
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Provider Business Mailing Address
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Address Line | 113 CROWN RIDGE DR
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City | NEDERLAND
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State | TX
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Zip | 77627-8919
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Country | US
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Telephone | 409-728-4543
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP125736
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License Number State | TX
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