| Pennie Jo Moore, LPN | |
|
9813 Us Highway 52, Stout, OH 45684-9066 | |
| (740) 858-6085 | |
| Not Available |
| Full Name | Pennie Jo Moore |
|---|---|
| Gender | Female |
| Speciality | Licensed Practical Nurse |
| Location | 9813 Us Highway 52, Stout, Ohio |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396919171 | NPI | - | NPPES |
| 2309586 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | PN109368 (Ohio) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Pennie Jo Moore, LPN 9813 Us Highway 52, Stout, OH 45684-9066 Ph: (740) 858-6085 | Pennie Jo Moore, LPN 9813 Us Highway 52, Stout, OH 45684-9066 Ph: (740) 858-6085 |
Mrs. Cristy Lynn Crabtree, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 418-b Pond Run Rd, Stout, OH 45684 Phone: 740-858-0840 | |
Ms. Cinda Charlton, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 9794 Us Highway 52, Stout, OH 45684 Phone: 740-858-0661 Fax: 740-354-0632 |