MEDICARE: ASHLEY NICOLE PENNINGTON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.023774	OH

General Provider Information

NPI Number	:	1285294884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY NICOLE PENNINGTON NP

Provider Business Mailing Address
First Line	:	805 COLUMBIA RD STE 109
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-1461
Country	:	US
Telephone Number	:	440-799-4224
Fax Number	:	440-799-4228

Provider Business Practice Location Address
First Line	:	805 COLUMBIA RD STE 101
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-1461
Country	:	US
Telephone Number	:	216-228-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2019
Last Update Date	:	04/29/2026

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Directions to “ ASHLEY NICOLE PENNINGTON NP” Practice Location

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