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General NPI Number Information
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NPI Number | 1326342239
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Entity Type | Individual
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Provider Name | PENELOPE LYNN VACHON DNP
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Gender | Female
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Dates
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Enumeration Date | 01/06/2011
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1565 SAM RITTENBERG BLVD STE 201
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City | CHARLESTON
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State | SC
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Zip | 29407-4138
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Country | US
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Telephone | 843-793-1353
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Fax | 843-818-4172
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Provider Business Mailing Address
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Address Line | 1565 SAM RITTENBERG BLVD STE 201
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City | CHARLESTON
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State | SC
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Zip | 29407-4138
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Country | US
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Telephone | 843-793-1353
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Fax | 843-818-4172
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 4436
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License Number State | SC
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