Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 13499R | LA |
NPI | 1023078953 |
---|---|
Provider Name | Erin Haley Pennison |
First Address | Houma, LA 70360-3403 |
Second Address | Houma, LA 70360-3403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 18/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1568635 | (05) | LA |
H15065 | (02) |