Regina Lynn Pennell, L.

Individual provider Active NPI Licensed Practical Nurse · New Concord, OH

NPI 1407189889 · NPPES record last updated Sep 16, 2009

Key facts

NPI
1407189889
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN131822 MEDS (OH)
Practice address
1000 Tammy Cir
New Concord, OH 43762-9684
Phone
(740) 261-5013
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN131822 MEDSOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN131822 MEDS OH Yes

Addresses

Primary practice location

1000 Tammy Cir
New Concord, OH 43762-9684

Mailing address

1000 Tammy Cir
New Concord, OH 43762-9684
Phone (740) 261-5013

Other providers in New Concord, OH

All providers in New Concord, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.