Provider Demographics
NPI:1194758987
Name:DUNNING- NEWELL, PENNY A (APRN FNP BC)
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:A
Last Name:DUNNING- NEWELL
Suffix:
Gender:F
Credentials:APRN FNP BC
Other - Prefix:
Other - First Name:PENNY
Other - Middle Name:A
Other - Last Name:HARM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65556-0777
Mailing Address - Country:US
Mailing Address - Phone:877-406-2662
Mailing Address - Fax:573-207-2773
Practice Address - Street 1:401 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAVOIS MILLS
Practice Address - State:MO
Practice Address - Zip Code:65037-6253
Practice Address - Country:US
Practice Address - Phone:877-406-2662
Practice Address - Fax:573-207-2773
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO089531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOC168373OtherMEDICARE B WHEATLANDS
MO428893804Medicaid
MO323440OtherFIRST GUARD
MO30034029OtherBC/BS CROSS OVER MEDICARE
MO326800OtherFAMILY HEALTH PARTNERS
MO326800OtherFAMILY HEALTH PARTNERS