LAURA KETTLE PENKAVA CRNP NPI 1962745315

NPI Information

NPI: 1962745315
Provider Name: LAURA KETTLE PENKAVA, CRNP
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

Organization: BIRMINGHAM INTERNAL MEDICINE ASSOCIATES, LLC

PECOS Registration: Yes

Address:
7191 CAHABA VALLEY RD
SUITE 300
BIRMINGHAM, AL
ZIP 35242
Phone: (205) 995-9909
Get Directions

Laura Kettle Penkava, CRNP is a primary care nurse practitioner in Birmingham, AL with 12 years of experience. Laura Kettle Penkava, CRNP NPI is 1962745315. 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:

7191 CAHABA VALLEY RD
SUITE 300
BIRMINGHAM, AL
ZIP 35242-402
Phone: (205) 995-9909
Fax: (205) 930-2063

The NPI 1962745315 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 4/4/2013 and was last updated on 8/25/2015.

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	363LP2300X	Nurse Practitioner	Primary Care	1-126161	ALABAMA	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	1-126161	OTHER	ALABAMA	CRNP

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: 11/14/2023

NPI Synchronization or Removal

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