Individual provider Active NPI

Michele P. Penland, RN

  • School Registered Nurse
  • Sierra Vista, AZ
National Provider Identifier
1205084654
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN133895 Issued in AZ
Practice address
5225 E Buena School Blvd
Sierra Vista, AZ 85635-2392
Phone
(520) 515-2873
NPI assigned
Aug 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN133895 AZ Primary

Addresses

Primary practice location

5225 E Buena School Blvd
Sierra Vista, AZ 85635-2392

Mailing address

PO Box 1421
Hereford, AZ 85615-1421
Phone (520) 366-0663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN133895AZMDSchool Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1205084654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1421",
            "city": "HEREFORD",
            "state": "AZ",
            "postal_code": "856151421",
            "telephone_number": "520-366-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 E BUENA SCHOOL BLVD",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352392",
            "telephone_number": "520-515-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENLAND",
        "first_name": "MICHELE",
        "middle_name": "P.",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "RN133895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.