Provider Demographics
NPI:1386123248
Name:PENROD, ERIKA MARIE
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:MARIE
Last Name:PENROD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1229
Mailing Address - Country:US
Mailing Address - Phone:207-331-7183
Mailing Address - Fax:
Practice Address - Street 1:325 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1229
Practice Address - Country:US
Practice Address - Phone:207-331-7183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-11
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist