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Caleb Pennock
Licensed Practical Nurse in Carterville, Illinois
NPI 1720535032

Caleb Pennock is a Licensed Practical Nurse based in Carterville, IL. Caleb Pennock practices in Carterville, IL. The NPI Number for Caleb Pennock is 1720535032 and holds a License No. 043.122929 (Illinois).

The current practice location address for Caleb Pennock is 4474 Old Route 13, Carterville, IL and can be reached out via phone at 618-889-7076.

Location: 4474 Old Route 13, Carterville, IL, 62918-3300
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1720535032
Provider Name
Caleb Pennock
Credential
Provider Entity Type
Individual
Gender
Male
Address
4474 Old Route 13, Carterville, IL, 62918-3300
Phone Number
618-889-7076
Fax Number
Provider Enumeration Date
09/02/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4474 Old Route 13
City
Carterville
State
Illinois
Zip
62918-3300
Phone Number
618-889-7076
Fax Number
person
Provider Business Mailing Address Details
Address
4474 Old Route 13
City
Carterville
State
Illinois
Zip
62918-3300
Phone Number
618-889-7076
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
043.122929 (Illinois)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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