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General NPI Number Information
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NPI Number | 1942894183
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Entity Type | Individual
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Provider Name | MEREDITH PENNINO APRN, CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2021
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 3020 MERCER UNIVERSITY DR STE 100
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City | ATLANTA
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State | GA
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Zip | 30341-4145
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Country | US
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Telephone | 770-458-3383
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Fax |
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Provider Business Mailing Address
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Address Line | 12460 CRABAPPLE RD # 202-277
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City | ALPHARETTA
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State | GA
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Zip | 30004-6602
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Country | US
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Telephone | 727-688-3138
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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 | APRN11011883
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN302421
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License Number State | GA
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