Penne, Jennifer Johanna

Penne, Jennifer Johanna is an individual health care provider with primary practice located at 2566 E Joyce Blvd , Fayetteville AR 72703-4553. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Penne, Jennifer Johanna can be contacted via phone (479) 935-1000.

Contact Information

Primary practice address
2566 E Joyce Blvd Fayetteville AR 72703-4553
Phone: (479) 935-1000
Fax: (479) 935-2000
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X R 72401 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 2021008266 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X A003632 Arkansas

Profile Details

NPI number 1497968101
LBN Legal business name Penne, Jennifer Johanna
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2007
Last updated Sep 19th, 2022 - 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 1497968101 NPPES
Arkansas MEDICAID 193306758
Arkansas MEDICAID 420094195

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