Individual provider · Type 1 NPI
Ebony Sharette Penn
Family Nurse Practitioner · Belleville, IL
NPI number
1477137693
Active
Practice location
1720 Shadow Ridge Ct Apt H
Belleville, IL 62221-3914
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 209022466 (IL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1477137693
Ebony Sharette Penn's National Provider Identifier is 1477137693, issued on May 12, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Belleville, IL. The record was last updated on May 12, 2021.