Champion, Penny L
Champion, Penny L is an individual health care provider with primary practice located at 414 5Th Ave , Albany GA 31701-1976. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Champion, Penny L can be contacted via phone (229) 883-4555.Contact Information
Primary practice address
414 5Th Ave
Albany GA 31701-1976
Phone: (229) 883-4555
Fax: (229) 888-0063
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | R079412 | Georgia |
Profile Details
| NPI number | 1265425797 |
|---|---|
| LBN Legal business name | Champion, Penny L |
| Credentials | Certified Nurse Midwife (CNM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2005 |
| Last updated | Dec 9th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265425797 | NPPES |
| Georgia | MEDICAID | 00787146A |
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