Doctor Name: | JULIA ELIZABETH PENNINGTON |
NPI Number: | 1114188281 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 5977P |
Business Practice Address: | 6813 W Highway 22 Crestwood, KY - 400147007 |
Business Phone Number: | 5022432622 |
Business Fax Number: | 5022432692 |
Mailing Address: | 6813 W Highway 22, CRESTWOOD |
State: | KY |
Postal Code: | 400147007 |
Phone Number: | 5022432622 |
Fax Number: | 5022432692 |
NPI Enumeration Date: | 06/22/2008 |
NPI Last Update Date: | 09/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 5977P |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |