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NPI Code Detail

MEDICARE: EARL PENCE PMHNP-BC

MEDICARE: EARL PENCE PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN.CNP.0042455OH

General Provider Information

NPI Number : 1558296053
Entity Type Code : Individual
Provider Name (Legal Business Name) : EARL PENCE PMHNP-BC
Provider Business Mailing Address
First Line : 5708 CHAMPAIGN AVE
Second Line :
City : BROOKPARK
State : OH
Zip : 44142-2515
Country : US
Telephone Number : 440-552-6897
Fax Number :
Provider Business Practice Location Address
First Line : 2500 METROHEALTH DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1900
Country : US
Telephone Number : 216-778-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ EARL PENCE PMHNP-BC” Practice Location

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