Provider Demographics
NPI:1659034668
Name:O'ROURKE, NATALIE RENE (APRN)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:RENE
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:APRN
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 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:9832 US HIGHWAY 441 STE 101
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-3984
Practice Address - Country:US
Practice Address - Phone:352-787-3341
Practice Address - Fax:352-787-7491
Is Sole Proprietor?:No
Enumeration Date:2021-10-17
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF10210675363L00000X
FLAPRN11016317363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner