Provider Demographics
NPI:1427335843
Name:BARTEL, PENNY LORRAINE (APN)
Entity type:Individual
Prefix:MRS
First Name:PENNY
Middle Name:LORRAINE
Last Name:BARTEL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:PENNY
Other - Middle Name:
Other - Last Name:HAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:180 E WINNIE LN
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-2268
Mailing Address - Country:US
Mailing Address - Phone:206-395-7870
Mailing Address - Fax:
Practice Address - Street 1:180 E WINNIE LN
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-2268
Practice Address - Country:US
Practice Address - Phone:775-546-2180
Practice Address - Fax:775-313-9727
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV001292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GD052ZMedicare PIN