Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APRN9367136 | FL |
NPI | 1003475211 |
---|---|
Provider Name | Allison Leigh Penny |
First Address | Orlando, FL 32869-1597 |
Second Address | Orlando, FL 32803-1424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2019 |
Last Update Date | 11/06/2019 |