Provider Demographics
NPI:1558612671
Name:PENNINGTON, LEONA ELIZABETH (PNP)
Entity type:Individual
Prefix:MS
First Name:LEONA
Middle Name:ELIZABETH
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:LEONA
Other - Middle Name:ELIZABETH
Other - Last Name:PENNINGTON-COTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1951
Mailing Address - Street 2:
Mailing Address - City:OCEAN SHORES
Mailing Address - State:WA
Mailing Address - Zip Code:98569-1951
Mailing Address - Country:US
Mailing Address - Phone:919-426-9179
Mailing Address - Fax:
Practice Address - Street 1:1020 ANDERSON DR STE 203
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1055
Practice Address - Country:US
Practice Address - Phone:360-533-6063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61620855363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics