Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | ARNP2875152 | FL |
NPI | 1235218900 |
---|---|
Provider Name | Mary Crosby Rysewyk |
First Address | Orlando, FL 32806-2031 |
Second Address | Orlando, FL 32806-2031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 14/12/2011 |