CALEB PENNOCK - NPI 1720535032 - Licensed Practical Nurse in Carterville, IL

Q: What is the provider's specialty?

The provider's specialty is Licensed Practical Nurse with taxonomy code 164W00000X.

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About Caleb Pennock NPPES

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

CALEB PENNOCK (NPI 1720535032) is an individual licensed practical nurse in Carterville, Illinois, licensed in Illinois (043.122929) and active in the NPI registry since September 2016.

NPPES Registry Identity

NPI1720535032

Entity TypeIndividualMale

Primary Taxonomy164W00000X

Provider Legal NameCALEB PENNOCK

Location Address4474 OLD ROUTE 13Carterville, IL 62918-3300

Mailing Address4474 Old Route 13Carterville, IL 62918-3300

Phone(618) 889-7076

Sole ProprietorYes

Enumeration DateSeptember 2, 2016

✔ NPI 1720535032 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 IL · 043.122929

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.

4474 OLD ROUTE 13, Carterville, IL 62918

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Frequently Asked Questions

What is Caleb Pennock's NPI number?

The NPI number assigned to this healthcare provider is 1720535032, enumerated as an "individual" on September 02, 2016.

Where is the provider located?

The provider is located at 4474 OLD ROUTE 13 CARTERVILLE, IL 62918 and the phone number is (618) 889-7076.

What is the provider's specialty?

Licensed Practical Nurse with taxonomy code 164W00000X.