Provider Demographics
NPI:1447905583
Name:PENNINGTON, ERIN ELIZABETH (LPN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:BINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:304 WESLEY DR
Mailing Address - Street 2:
Mailing Address - City:WOOD RIVER
Mailing Address - State:IL
Mailing Address - Zip Code:62095-2266
Mailing Address - Country:US
Mailing Address - Phone:618-258-7592
Mailing Address - Fax:
Practice Address - Street 1:1209 NATALYNS TRCE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IL
Practice Address - Zip Code:62254-1843
Practice Address - Country:US
Practice Address - Phone:618-803-1434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043.123760164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse