Individual provider · Type 1 NPI
Maritta A. Penegor, NP-BC
Nurse Practitioner · Dyer, IN
Practice location
24 Joliet St, Suite 401
Dyer, IN 46311-1705
Fax (219) 865-3599
Mailing address
3615 Park Dr, Suite 203
Olympia Fields, IL 60461-1186
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 70000040A (IN) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1205947983
Maritta A. Penegor, NP-BC's National Provider Identifier is 1205947983, issued on Aug 31, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Dyer, IN. The record was last updated on Sep 27, 2007.