PENNY ROTH - NPI 1083216543 - Licensed Practical Nurse in Mandan, ND

Q: What is Penny Roth's NPI number?

The NPI number for Penny Roth is 1083216543. It was assigned to this individual provider in the NPPES registry on November 10, 2020.

Q: What is Penny Roth's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Penny Roth was last updated on November 10, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Penny Roth NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENNY ROTH (NPI 1083216543) is an individual licensed practical nurse in Mandan, North Dakota, licensed in Virginia (0002059986) and active in the NPI registry since November 2020.

NPPES Registry Identity

NPI1083216543

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NamePENNY ROTH

Location Address1200 COLLINS AVEMandan, ND 58554-2066

Mailing Address1200 Collins AveMandan, ND 58554-2066 · (701) 663-5373

Phone(701) 663-5373

Sole ProprietorNo

Enumeration DateNovember 10, 2020

NPPES CertifiedNovember 10, 2020

✔ NPI 1083216543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in VA · 0002059986

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

1200 COLLINS AVE, Mandan, ND 58554

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