Provider Demographics
NPI:1487451027
Name:PENNINGTON, KATELYNN (RT(R))
Entity type:Individual
Prefix:
First Name:KATELYNN
Middle Name:
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:RT(R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 ARBOR RD NW
Mailing Address - Street 2:
Mailing Address - City:MINERVA
Mailing Address - State:OH
Mailing Address - Zip Code:44657-8756
Mailing Address - Country:US
Mailing Address - Phone:330-614-4946
Mailing Address - Fax:
Practice Address - Street 1:1972 CLARK AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-3993
Practice Address - Country:US
Practice Address - Phone:330-823-7907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant