Penn, Mary Catharine

Penn, Mary Catharine is an individual health care provider with primary practice located at 400 Colonnade Dr Suite 160, Ponte Vedra FL 32081. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Penn, Mary Catharine can be contacted via phone (904) 824-1020.

Contact Information

Primary practice address
400 Colonnade Dr Suite 160 Ponte Vedra FL 32081
Phone: (904) 824-1020
Fax: (904) 824-5333
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2849942 Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN2849942 Florida

Profile Details

NPI number 1861488546
LBN Legal business name Penn, Mary Catharine
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated Feb 13th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861488546 NPPES
Florida MEDICAID 3050408-00

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