MEDICARE: COLLEEN ANNE IRWIN FNP-C, PMHNP

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	363L00000X	Nurse Practitioner	9379521	FL
2	363LF0000X	Family Nurse Practitioner	RN150271 NP	GA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	9379521	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	:	1922189190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLEEN ANNE IRWIN FNP-C, PMHNP

Provider Business Mailing Address
First Line	:	425 W COLONIAL DR STE 104
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	407-392-9244
Fax Number	:	407-569-4137

Provider Business Practice Location Address
First Line	:	425 W COLONIAL DR STE 104
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	407-392-9244
Fax Number	:	407-569-4137

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	06/16/2025

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