| Doctor Name: | PENNY JAMES MATLOCK |
| NPI Number: | 1043557069 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 145631 |
| Business Practice Address: | 1985 Startown Rd Suite 102 Hickory, NC - 286028307 |
| Business Phone Number: | 8283274745 |
| Business Fax Number: | 8283223569 |
| Mailing Address: | 1985 Startown Rd, Suite 102 HICKORY |
| State: | NC |
| Postal Code: | 286028307 |
| Phone Number: | 8283274745 |
| Fax Number: | 8283223569 |
| NPI Enumeration Date: | 01/10/2013 |
| NPI Last Update Date: | 02/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 145631 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |