Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 0007949 | CO |
NPI | 1609496991 |
---|---|
Provider Name | Lauren N Penn |
First Address | Colorado Springs, CO 80916-4607 |
Second Address | Colorado Springs, CO 80910-7713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2020 |
Last Update Date | 16/04/2020 |