=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720982937
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BETSY PENNINGTON MS, RD, LD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2026
-----------------------------------------------------
Last Update Date | 10/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 137 W MAIN ST
-----------------------------------------------------
City | FLORENCE
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39073-8106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-954-3881
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 137 W MAIN ST
-----------------------------------------------------
City | FLORENCE
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39073-8106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-954-3881
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | D-2155
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------