Provider Demographics
NPI:1689566879
Name:ALBAUGH, PENNY LAINE
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:LAINE
Last Name:ALBAUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 STATE ROUTE 46
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9669
Mailing Address - Country:US
Mailing Address - Phone:330-240-3112
Mailing Address - Fax:
Practice Address - Street 1:7311 STATE ROUTE 46
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-9669
Practice Address - Country:US
Practice Address - Phone:330-240-3112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide