Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | APRN9328815 | FL |
Y | 363LA2200X | Nurse Practitioner - Adult Health | ARNP9328815 | FL |
N | 363LG0600X | Nurse Practitioner - Gerontology | ARNP9328815 | FL |
NPI | 1073989547 |
---|---|
Provider Name | Mrs. Maidelys Rohan |
First Address | Gainesville, FL 32610-0001 |
Second Address | Gainesville, FL 32611-2038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2015 |
Last Update Date | 24/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104447700 | (05) | FL |