Penning, Kieran L

Penning, Kieran L is an individual health care provider with primary practice located at 9660 Wicker Avenue 2Nd Floor, St John IN 46373-9487. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Penning, Kieran L can be contacted via phone (219) 226-2380.

Contact Information

Primary practice address
9660 Wicker Avenue 2Nd Floor St John IN 46373-9487
Phone: (219) 226-2380
Fax: (219) 226-2381
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71001464A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 71001464A Indiana

Profile Details

NPI number 1629166855
LBN Legal business name Penning, Kieran L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Jun 23rd, 2010 - about 14 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 1629166855 NPPES
Indiana MEDICAID 200932310

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