National Provider Identifier Database

SUSAN K PENNYPACKER, FNP C – NPI #1194717157
Family


Contact Information

SUSAN K PENNYPACKER, FNP C
140 OLD GRAY STATION RD
SUITE 200
GRAY, TN37615
Phone: 423-477-2042
Fax: 423-477-7571
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for SUSAN K PENNYPACKER

NPI Number 1194717157
Credentials FNP C
Entity Individual
Enumeration date 08/16/2005
Last updated 11/08/2011 - About 15 years ago
Sole proprietor1 Yes
Identifiers
  • TN License #: 6966
  • TN Medicaid: 5440517
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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