PENNY ROTH NPI 1083216543

NPI Information

  • NPI: 1083216543
  • Provider Name: PENNY ROTH
  • Classification: Licensed Practical Nurse - 164W00000X
  • Entity Type: Individual
  • Address: 1200 COLLINS AVE
    MANDAN, ND
    ZIP 58554
  • Phone: (701) 663-5373

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NPI Details

Penny Roth is a licensed practical nurse in Mandan, ND. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Penny Roth NPI is 1083216543. 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:

1200 COLLINS AVE
MANDAN, ND
ZIP 58554-066
Phone: (701) 663-5373

The enumeration date for this NPI number is 11/10/2020 and was last updated on 11/10/2020.

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
1164W00000XLicensed Practical Nurse0002059986VIRGINIAYes

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: 3/30/2025

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