Provider Demographics
NPI:1073344131
Name:PENNY, ALLISON LANE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:LANE
Last Name:PENNY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-369-8100
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:5000 ODONAVAN BLVD STE 404
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-6355
Practice Address - Country:US
Practice Address - Phone:225-369-8100
Practice Address - Fax:225-369-8140
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP234914207Q00000X
LA234914363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty