MEDICARE: MS. MARY CATHARINE PENN ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2849942	FL
2	363L00000X	Nurse Practitioner	APRN2849942	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861488546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY CATHARINE PENN ARNP

Provider Business Mailing Address
First Line	:	PO BOX 45443
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84145-0443
Country	:	US
Telephone Number	:	904-202-1032
Fax Number	:	904-376-4107

Provider Business Practice Location Address
First Line	:	400 COLONNADE DR
Second Line	:	SUITE 160
City	:	PONTE VEDRA
State	:	FL
Zip	:	32081
Country	:	US
Telephone Number	:	904-824-1020
Fax Number	:	904-824-5333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	02/13/2021

Similar Medicare Providers

1619823796 — SABRINA RENSINK
Practice Location Address:

50 VENTURE VALLY CT STE 19
PONTE VEDRA, FL
32081-6252

Practice Phone: 904-429-8113
Practice Fax:

1962358655 — TALK IS SWEET THERAPY LLC
Practice Location Address:

90 FORT WADE RD
PONTE VEDRA, FL
32081-5146

Practice Phone: 904-834-9796
Practice Fax:

1619940251 — WILLIAM S MACRI BS PT
Practice Location Address:

269 PALM CREST DR
PONTE VEDRA, FL
32081-2001

Practice Phone: 917-757-5829
Practice Fax:

1518969575 — DR. ANGELA KAY STAPLETON-MACKENZIE M.D.
Practice Location Address:

400 COLONNADE DR STE 160
PONTE VEDRA, FL
32081-6236

Practice Phone: 904-824-1020
Practice Fax: 904-390-7503

1306821236 — DR. JOEL ALAN AHLGRIM D.O.
Practice Location Address:

400 COLONNADE DR STE 230
PONTE VEDRA, FL
32081-6237

Practice Phone: 904-376-3970
Practice Fax: 904-376-3435

1366429862 — DR. AMANDA BARTELL D.P.M.
Practice Location Address:

465 TOWN PLAZA AVE STE A
PONTE VEDRA, FL
32081-5164

Practice Phone: 904-236-5023
Practice Fax: 904-236-5073

Directions to “ MS. MARY CATHARINE PENN ARNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.