Penrod, Misty Marie

Penrod, Misty Marie is an individual health care provider with primary practice located at 3 Progressive St , Bluffton SC 29910-5165. 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 / Family is her primary health care specialty. Penrod, Misty Marie can be contacted via phone (843) 548-0533.

Contact Information

Primary practice address
3 Progressive St Bluffton SC 29910-5165
Phone: (843) 548-0533
Fax: (843) 815-9121
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN.251801-COA1 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 251801 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 23137 South Carolina

Profile Details

NPI number 1356606768
LBN Legal business name Penrod, Misty Marie
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2012
Last updated Feb 20th, 2023 - 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 1356606768 NPPES
South Carolina MEDICAID NP6344
South Carolina MEDICAID 0091989

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