Bucilla, Pennie Elizabeth

Bucilla, Pennie Elizabeth is an sole proprietor health care provider with primary practice located at 1500 Mcandrews Rd W , Burnsville MN 55337. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Bucilla, Pennie Elizabeth can be contacted via phone (952) 892-9393.

Contact Information

Primary practice address
1500 Mcandrews Rd W Burnsville MN 55337
Phone: (952) 892-9393
Fax: (952) 800-8892
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R156407-9 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R156407-9 CNP1972 Minnesota

Profile Details

NPI number 1104225499
LBN Legal business name Bucilla, Pennie Elizabeth
Credentials APRN CNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 22nd, 2014
Last updated Sep 23rd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104225499 NPPES
Minnesota Other 1104225499 MINNESOTA HEALTH CARE PROGRAMS (MHCP)

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