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General NPI Number Information
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NPI Number | 1558612671
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Entity Type | Individual
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Provider Name | LEONA ELIZABETH PENNINGTON PNP
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Gender | Female
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Dates
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Enumeration Date | 09/28/2012
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 1020 ANDERSON DR STE 203
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City | ABERDEEN
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State | WA
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Zip | 98520-1055
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Country | US
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Telephone | 360-533-6063
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1951
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City | OCEAN SHORES
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State | WA
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Zip | 98569-1951
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Country | US
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Telephone | 919-426-9179
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP61620855
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License Number State | WA
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