Krysta Penn

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1159364 Issued in KY

Practice address

506 Malcolm Ave
Louisville, KY 40223-2535

Phone

(502) 271-8486

Fax

(502) 271-8486

NPI assigned

Aug 27, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Krysta Lathon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1619856473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 MALCOLM AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232535",
            "telephone_number": "502-271-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MALCOLM AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232535",
            "telephone_number": "502-271-8486",
            "fax_number": "502-271-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "KRYSTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1159364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTA",
            "last_name": "LATHON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amberly S Pendley
• Lynn M Pendley, M.S., R.D., L.D.
• Chaisak Pengvanich, M.D.
• Tori Marissa Penick, PHARM.D.
• Amber June Penn, PSY.D.
• Lee Thomas Penn
• Roberto A Penne-Casanova, MD
• Koryn Pennebaker
• Aaron M Pennell, M.D.
• Heather W Pennell, CRNA

• All providers in Louisville, KY
• Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.