Individual provider · Type 1 NPI

Kathlyn Lara Penick, PA

Physician Assistant · Orange City, FL

NPI number 1558091157 Active

Practice location

2824 Enterprise Rd
Orange City, FL 32763-8428

Call (386) 774-7411 Map

Fax (386) 774-7412

Mailing address

PO Box 102222
Atlanta, GA 30368-2222

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA9116046 (FL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1558091157

Kathlyn Lara Penick, PA's National Provider Identifier is 1558091157, issued on Jun 15, 2022. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Orange City, FL. The record was last updated on Jul 7, 2026.