Jennifer Nicole Penna

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

159229 Issued in WI

Practice address

224 Connelly Dr
Jefferson, WI 53549

Phone

(920) 650-4414

NPI assigned

Feb 27, 2023

Last updated

Feb 27, 2023By the provider in NPPES

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

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1740989045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 CHAPEL HILL DR",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530389470",
            "telephone_number": "920-390-0839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 CONNELLY DR",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "53549",
            "telephone_number": "920-650-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNA",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "159229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Elizabeth Palm, BA, RPH
• Tiffany Palm, PHARM.D.
• Nichole N Pankow, D.C.
• Mary Rose Parizek
• Susan Christine Parrish, MS/CCC-SLP
• Kelley Potila
• Kimberly Jo Propp, LPC
• Amy Prouty, LPC, CSAC
• Rachel Johnston Puda, DPT
• Linda Jean Puerner-Fischer, RN

• Registered Nurse in Jefferson, WI
• Providers in Jefferson, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.