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General NPI Number Information
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NPI Number | 1710944863
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Entity Type | Individual
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Provider Name | PENNI LORRAINE CREMER PMHCNS-BC
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Gender | Female
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 1424 E 91ST ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1902
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Country | US
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Telephone | 317-709-3365
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Fax |
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Provider Business Mailing Address
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Address Line | 12539 PEBBLEPOINTE PASS
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City | CARMEL
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State | IN
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Zip | 46033
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Country | US
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Telephone | 317-709-3365
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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 | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 70000131A
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License Number State | IN
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