Penkala, Mary Elizabeth

Penkala, Mary Elizabeth is an individual health care provider with primary practice located at 6847 N Chestnut St Ste 115 , Ravenna OH 44266-3929. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Penkala, Mary Elizabeth can be contacted via phone (330) 297-6055.

Contact Information

Primary practice address
6847 N Chestnut St Ste 115 Ravenna OH 44266-3929
Phone: (330) 297-6055
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X APRN.CNS.01044 Ohio

Profile Details

NPI number 1104260413
LBN Legal business name Penkala, Mary Elizabeth
Credentials Clinical Nurse Specialist (CNS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2013
Last updated Jan 15th, 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 1104260413 NPPES
Ohio MEDICAID 0083512

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