Provider Demographics
NPI:1386957140
Name:PENWELL, ROBIN LYNNETTE (LPN)
Entity type:Individual
Prefix:MISS
First Name:ROBIN
Middle Name:LYNNETTE
Last Name:PENWELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2672 LORIS WAY
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8285
Mailing Address - Country:US
Mailing Address - Phone:740-606-8567
Mailing Address - Fax:
Practice Address - Street 1:2672 LORIS WAY
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8285
Practice Address - Country:US
Practice Address - Phone:740-606-8567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.135875-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse