Tabitha Renee Penny, BSN, RN

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

4704248744 Issued in MI

Practice address

212 Winston Dr
Marshall, MI 49068-8526

Phone

(269) 781-9867

NPI assigned

May 21, 2024

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

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1992544894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 COPPER OAKS ST",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490025891",
            "telephone_number": "269-245-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 WINSTON DR",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490688526",
            "telephone_number": "269-781-9867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10310 Miller Dr",
            "address_purpose": "LOCATION",
            "city": "Galesburg",
            "state": "MI",
            "postal_code": "490539556",
            "country_code": "US",
            "telephone_number": "269-286-7150",
            "fax_number": "269-286-7151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNY",
        "first_name": "TABITHA",
        "middle_name": "RENEE",
        "credential": "BSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MI",
            "license": "4704248744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric James Pearson, DO
• Jillian Pehrson
• Carla Vannesse Pejakovich, P.T.
• Mikeayla Pellegrino
• Laura Anne Pence, M.D.
• Katherine Leigh Pestun Moore, DO
• Katherine Peterson
• Hilary Phelps, M.S., OTR/L
• Physiotherapy Associates Inc
• Kurt Rudiger Piatkowski, DO

• Ambulatory Care Registered Nurse in Marshall, MI
• Providers in Marshall, MI by specialty
• Ambulatory Care Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.