MARY ELIZABETH PENKALA CNS NPI 1104260413

NPI Information

NPI: 1104260413
Provider Name: MARY ELIZABETH PENKALA, CNS
Classification: Clinical Nurse Specialist - 364SA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
6847 N CHESTNUT ST STE 115
RAVENNA, OH
ZIP 44266
Phone: (330) 297-6055
Get Directions

Mary Elizabeth Penkala, CNS is an adult health clinical nurse specialist in Ravenna, OH with 35 years of experience. Mary Elizabeth Penkala, CNS NPI is 1104260413. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6847 N CHESTNUT ST STE 115
RAVENNA, OH
ZIP 44266-929
Phone: (330) 297-6055

The NPI 1104260413 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/18/2013 and was last updated on 1/15/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	364SA2200X	Clinical Nurse Specialist	Adult Health	APRN.CNS.01044	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0083512	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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