KIERAN L PENNING (NPI# 1629166855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629166855 |
| Entity Type | Individual |
| Full Name | KIERAN L PENNING |
| Credential | NP |
| Practice Address |
9660 Wicker Avenue 2nd Floor St John IN 46373-9487 |
| Practice Telephone | 2192262380 |
| Practice Fax Number | 2192262381 |
| Mailing Telephone | 2192262380 |
| Mailing Fax Number | 2192262381 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2010-06-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
71001464A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
71001464A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200932310 | 05 |
| Street Address |
9660 WICKER AVENUE 2ND FLOOR |
| City | ST JOHN |
| State | IN |
| Zip Code | 46373-9487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841296530 | Katrina L. Lee | Obstetrics & Gynecology | 9660 Wicker Avenue, St John, IN 46373-9487 | 2005-06-27 |
| 1558458554 | Bina K Parekh | Family Medicine | 9660 Wicker Avenue, St John, IN 46373-9487 | 2006-10-10 |
| 1104811637 | Snezana Barancyk | Nurse Practitioner | 9660 Wicker Avenue, St John, IN 46373-9487 | 2005-09-12 |
| 1912908781 | Thomas Michael Anger | Pediatrics | 9660 Wicker Avenue, 2nd Floor, St John, IN 46373-9487 | 2005-08-03 |
| 1649271412 | Robert A Dershewitz | Pediatrics | 9660 Wicker Avenue, 2nd Floor, St John, IN 46373-9487 | 2005-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023641123 | Lisa A Arteaga | Occupational Therapy Assistant | 10700 Park Place of St John, St John, IN 46373 | 2020-02-17 |
| 1306493507 | Athletico Ltd | Physical Therapist | 10081 Wicker Ave #4, Saint John, IN 46373 | 2019-08-22 |
| 1083014971 | Courtney Olavarria | Registered Nurse | 8915 West 93rd Avenue, Clark Middle School, Saint John, IN 46373 | 2014-08-27 |
| 1316368111 | Tracy Lynn Wargo | Registered Nurse | 8801 Wicker Ave., Kolling Elementary, St. John, IN 46373 | 2013-12-20 |
| 1245587989 | Joshua Dejong | Physical Therapist | 10200 Wicker Ave Ste 1, Saint John, IN 46373 | 2012-08-13 |
| 1053406629 | Corlin Alden Stein | Chiropractor | 9161 Wicker Avenue (us 41), St. John, IN 46373 | 2006-10-03 |
| 1235190216 | Tarak R Chokshi | Internal Medicine | 10200 Wicker Avenue, St John, IN 46373 | 2006-03-30 |
| 1154397057 | Norbert A Matulis | Dentist | 9207 Wicker Avenue, St John, IN 46373 | 2006-02-28 |
| 1568462729 | Keith R. Pitchford | Orthopaedic Surgery | 9615 Keilman Street, Saint John, IN 46373 | 2005-07-28 |
| 1528483021 | Creating Smiles PC | Dentist | 8217 Wicker Ave, St John, IN 46373 | 2014-02-20 |
| Find all providers in zip 46373 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822844 | Kelsey M Knight | Nurse Practitioner | 705 Riley Hospital Dr Ste 1601, Indianapolis, IN 46202-5109 | 2020-08-21 |
| 1699306241 | Amber Barney | Nurse Practitioner | 3611 S Lafountain St, Kokomo, IN 46902 | 2020-02-03 |
| 1700420031 | Randi D Bragg | Nurse Practitioner | Marion Pediatrics, 1411w Bella Drive, Marion, IN 46953-5250 | 2019-10-30 |
| 1659923761 | Elizabeth Marie Bowen | Nurse Practitioner | 13914 Southeastern Pkwy Ste 300, Fishers, IN 46037-7126 | 2019-07-10 |
| 1912462664 | Mindy Kay Krsak | Nurse Practitioner | 3229 Broadway Ste 205, Gary, IN 46409-1038 | 2019-02-06 |
| 1497221154 | Christina Ownbey | Nurse Practitioner | 517 Ball Dr Unit 302, Hanover, IN 47243-9656 | 2018-10-22 |
| 1578056842 | Jenna Elizabeth Bednarski | Nurse Practitioner | 3741 Rome Dr Ste B, Lafayette, IN 47905-4490 | 2018-06-12 |
| 1427594696 | Alecia A Woody | Nurse Practitioner | 3400 Lafayette Rd, Suite 200, Shalom Health Care Center Inc, Indianapolis, IN 46222-1146 | 2017-01-12 |
| 1043688211 | Mary Hendrix | Nurse Practitioner | 3118 S Lafountain St # At, Kokomo, IN 46902-3710 | 2015-09-04 |
| 1487022810 | Hannah Renfrow | Nurse Practitioner | 1411 W Bella Drive, Marion, IN 46953 | 2015-09-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.