Tyler Penn
Community Health Worker in Prestonsburg, KY. Individual provider (NPI-1).
NPI number1164095451
StatusActive
Last updated in NPPESJul 23, 2021
Details
- NPI
- 1164095451
- Entity type
- Individual (NPI-1)
- Name
- Tyler Penn
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 23, 2021
- Certification date
- Jul 23, 2021
- Last updated
- Jul 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
Practice location
104 S Front AvePrestonsburg, KY 41653-1614
Phone 606-886-8572 · Fax 606-886-4433
Mailing address
104 S Front AvePrestonsburg, KY 41653-1614
Phone 606-886-8572 · Fax 606-886-4433
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All 1,162 Community Health Worker providers in Prestonsburg · All 3,624 providers in Prestonsburg
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