Provider Demographics
NPI:1760354161
Name:PENNIX, ANGEL M
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:M
Last Name:PENNIX
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 1:413 TYLER ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-3446
Mailing Address - Country:US
Mailing Address - Phone:419-202-7227
Mailing Address - Fax:
Practice Address - Street 1:413 TYLER ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-3446
Practice Address - Country:US
Practice Address - Phone:419-202-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty