Individual ProviderDenise PennicookeNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664(770) 324-6938(678) 333-4888PECOS EnrollmentBased on the most recent information from CMS, provider Denise Pennicooke is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1962962530Provider TypeIndividualFull NamePennicooke, DeniseCredentialNPGenderFemaleSole ProprietorYesEnumeration Date3/20/2019Last Updated9/22/2020Contact InformationPractice LocationPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664Phone(770) 324-6938FaxUnlisted FaxMailing LocationMailing Address5680 Sterling Ct, Cumming, GA 30040-0579Phone(678) 333-4888FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN227540Georgia