Nicole C Penkwitz | Dallas, TX • PECOS Search

Nicole C Penkwitz

Registered Nurse

Nursing Service Providers

13601 Preston Rd Ste 210w, Dallas, TX 75240-4986

PECOS Enrollment

Based on the most recent information from CMS, provider Nicole C Penkwitz does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1528657087
Provider Type
Individual
Full Name
Penkwitz, Nicole C
Gender
Female

Sole Proprietor
No
Enumeration Date
1/11/2021
Last Updated
1/11/2021

Contact Information

Practice Location

13601 Preston Rd Ste 210w, Dallas, TX 75240-4986

Unlisted Fax

Mailing Location

13601 Preston Rd Ste 210w, Dallas, TX 75240-4986

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 163W00000X Primary	Description Registered Nurse Nursing Service Providers	License 958102 Texas