Provider Demographics
NPI:1164407961
Name:REISCHMAN, ROSALYN R (PHD, ARNP)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:R
Last Name:REISCHMAN
Suffix:
Gender:F
Credentials:PHD, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100197
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0197
Mailing Address - Country:US
Mailing Address - Phone:904-244-5175
Mailing Address - Fax:904-244-3246
Practice Address - Street 1:101 S. NEWELL DRIVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611
Practice Address - Country:US
Practice Address - Phone:904-244-5175
Practice Address - Fax:904-244-3246
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL554532364SA2100X, 364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
Not Answered364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health