Danette Pengilly
Nurse Practitioner - Gerontology
310 N 10th St
Bismarck
, North Dakota 58501-4516
Danette Pengilly
Nurse Practitioner - Gerontology
310 N 10th St
Bismarck
, North Dakota 58501-4516
(701) 530-7484
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Danette Pengilly
- 310 N 10th St
- Bismarck, ND
- Zip : 58501-4516
- Fax : (701) 530-7484
- Phone : (701) 530-7500
Second Address
- Danette Pengilly
- 310 N 10th St
- Bismarck, ND
- Zip : 58501-4516
- Fax : (701) 530-7484
- Phone : (701) 530-7500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | R23780 | ND |
National Provider Identifier
| NPI | 1013016989 |
|---|---|
| Provider Name | Danette Pengilly |
| First Address | Bismarck, ND 58501-4516 |
| Second Address | Bismarck, ND 58501-4516 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/09/2006 |
| Last Update Date | 29/02/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1013016989 | NPI (01) | |
| P00209023 | RAILROAD MEDICARE (01) | ND |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.