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General NPI Number Information
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NPI Number | 1053366534
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Entity Type | Organization
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Legal Business Name | JESSICA A. PENNINGTON
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 06/08/2010
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Provider Practice Location Address
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Address Line | 793 EASTERN BYPASS SUITE 213
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City | RICHMOND
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State | KY
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Zip | 40475
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Country | US
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Telephone | 859-625-5018
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Fax | 859-625-5539
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Provider Business Mailing Address
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Address Line | 793 EASTERN BYPASS SUITE 213
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City | RICHMOND
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State | KY
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Zip | 40475
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Country | US
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Telephone | 859-625-5018
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Fax | 859-625-5539
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESSICA ABNEY PENNINGTON
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Credential | MD
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Telephone | 859-625-5018
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | KY
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