Healthcare Provider Details

I. General information

NPI: 1598123036
Provider Name (Legal Business Name): SUSAN M PENNEY APRN, CNM, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN M MITCHELL

II. Dates (important events)

Enumeration Date: 01/28/2016
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 W MILLER ST # MP326
ORLANDO FL
32806-2031
US

IV. Provider business mailing address

83 W MILLER ST # MP326
ORLANDO FL
32806-2031
US

V. Phone/Fax

Practice location:
  • Phone: 321-842-9863
  • Fax: 321-843-2068
Mailing address:
  • Phone: 321-842-9863
  • Fax: 321-843-2068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11001441
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11001441
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number065254-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: