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NPI Code Detail

MEDICARE: MRS. BRANDI LE ANN PENNINGTON CNP

MEDICARE: MRS. BRANDI LE ANN PENNINGTON CNP
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
1207Q00000XFamily Medicine PhysicianAPRN.CNP.023673OH
2363LF0000XFamily Nurse PractitionerAPRN.CNP.023673OH

General Provider Information

NPI Number : 1528534955
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRANDI LE ANN PENNINGTON CNP
Provider Business Mailing Address
First Line : 41 FORD RD S
Second Line :
City : MANSFIELD
State : OH
Zip : 44905-2931
Country : US
Telephone Number : 740-294-9849
Fax Number :
Provider Business Practice Location Address
First Line : 11660 UPPER GILCHRIST RD
Second Line :
City : MOUNT VERNON
State : OH
Zip : 43050-9084
Country : US
Telephone Number : 740-399-8008
Fax Number : 740-399-8012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2018
Last Update Date : 05/21/2026

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