Penick, Tierra Kaye

Penick, Tierra Kaye is an individual health care provider with primary practice located at 3200 Sycamore Ct Ste 1B , Columbus IN 47203-1545. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Penick, Tierra Kaye can be contacted via phone (812) 378-9027.

Contact Information

Primary practice address
3200 Sycamore Ct Ste 1B Columbus IN 47203-1545
Phone: (812) 378-9027
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 134706 Indiana

Profile Details

NPI number 1447825070
LBN Legal business name Penick, Tierra Kaye
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2021
Last updated May 25th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447825070 NPPES
Indiana MEDICAID 134706

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