Pennington, Karen R

Pennington, Karen R is an individual health care provider with primary practice located at 921 Greeley St S , Stillwater MN 55082. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Pennington, Karen R can be contacted via phone (651) 439-1234.

Contact Information

Primary practice address
921 Greeley St S Stillwater MN 55082
Phone: (651) 439-1234
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1242 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10413 Minnesota

Profile Details

NPI number 1487766820
LBN Legal business name Pennington, Karen R
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Feb 25th, 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 1487766820 NPPES
Wisconsin MEDICAID 42995400

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