| Doctor Name: | MS. SUSAN KAY PENNYPACKER |
| NPI Number: | 1194717157 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP C |
| License Number: | 6966 |
| Business Practice Address: | 140 Old Gray Station Rd Suite 200 Gray, TN - 37615 |
| Business Phone Number: | 4234772042 |
| Business Fax Number: | 4234777571 |
| Mailing Address: | 140 Old Gray Station Rd, Suite 200 GRAY |
| State: | TN |
| Postal Code: | 37615 |
| Phone Number: | 4234772042 |
| Fax Number: | 4234777571 |
| NPI Enumeration Date: | 08/16/2005 |
| NPI Last Update Date: | 11/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 6966 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |