Linnea Pennycuff, RD, CD | |
4011 S Monroe Medical Park Blvd, Bloomington, IN 47403-8000 | |
(812) 825-1111 | |
Not Available |
Full Name | Linnea Pennycuff |
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Gender | Female |
Speciality | Dietitian, Registered - Nutrition, Metabolic |
Location | 4011 S Monroe Medical Park Blvd, Bloomington, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1871587451 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133VN1006X | Dietitian, Registered - Nutrition, Metabolic | 37001516A (Indiana) | Primary |
Provider Name | Monroe Medical Group Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1568627206 PECOS PAC ID: 0446576680 Enrollment ID: O20150305000230 |
Mailing Address | Practice Location Address |
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Linnea Pennycuff, RD, CD 4011 S Monroe Medical Park Blvd, Bloomington, IN 47403-8000 Ph: (812) 825-1111 | Linnea Pennycuff, RD, CD 4011 S Monroe Medical Park Blvd, Bloomington, IN 47403-8000 Ph: (812) 825-1111 |
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