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General NPI Number Information
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NPI Number | 1811441256
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Entity Type | Individual
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Provider Name | KATHERINE PENETAR
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Gender | Female
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Dates
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Enumeration Date | 08/14/2016
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 1250 S CEDAR CREST BLVD STE 310
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City | ALLENTOWN
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State | PA
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Zip | 18103-6381
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Country | US
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Telephone | 610-402-6890
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89102-2329
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Country | US
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Telephone | 702-383-2000
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | SP016459
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 870750
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License Number State | NV
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