Penner, Keith Edwin

Penner, Keith Edwin is an individual health care provider with primary practice located at 207 Old Lexington Rd , Thomasville NC 27360-3428. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Penner, Keith Edwin can be contacted via phone (336) 476-2586.

Contact Information

Primary practice address
207 Old Lexington Rd Thomasville NC 27360-3428
Phone: (336) 476-2586
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 051810 North Carolina

Profile Details

NPI number 1013944974
LBN Legal business name Penner, Keith Edwin
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Oct 27th, 2020 - about 5 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 1013944974 NPPES
North Carolina MEDICAID 8051375
North Carolina Other 4630058715

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