Penny Rena Edwards, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

67102 Issued in TN

Practice address

101 Lena Dr
Rogersville, TN 37857-2951

Phone

(423) 272-9239

Fax

(423) 467-3644

NPI assigned

May 10, 2016

Last updated

May 10, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1982050860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LENA DR",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378572951",
            "telephone_number": "423-272-9239",
            "fax_number": "423-467-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "PENNY",
        "middle_name": "RENA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "67102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Lee Duncan, LCSW
• Felisa M Dunlap, LMFT
• Crystal Shanelle Dyer, M.D.
• Kristen Dykes, FNP
• Douglas Chase Edwards, PT, DPT
• Kay B Elkins, RNC
• Evolution Medical and Aesthetics PLLC
• James Robert Ewing, ARRT RT
• Executive Regenerative Health
• Paul Douglas Fairbanks, LCPC / LPC

• Licensed Practical Nurse in Rogersville, TN
• Providers in Rogersville, TN by specialty
• Licensed Practical Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.