KIERAN L PENNING NP NPI 1629166855

NPI Information

  • NPI: 1629166855
  • Provider Name: KIERAN L PENNING, NP
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: 9660 WICKER AVENUE
    2ND FLOOR
    ST JOHN, IN
    ZIP 46373
  • Phone: (219) 226-2380

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NPI Details

Kieran L Penning, NP is a pediatrics nurse practitioner in St John, IN. Kieran L Penning, NP NPI is 1629166855. 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:

9660 WICKER AVENUE
2ND FLOOR
ST JOHN, IN
ZIP 46373-487
Phone: (219) 226-2380
Fax: (219) 226-2381

The enumeration date for this NPI number is 10/11/2006 and was last updated on 6/23/2010.

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
1363LF0000XNurse PractitionerFamily71001464AINDIANANo
2363LP0200XNurse PractitionerPediatrics71001464AINDIANAYes

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
1200932310MEDICAIDINDIANA

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: 11/21/2025

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