Provider Demographics
NPI:1760948665
Name:WYROSDICK, REBEKAH LEIGH (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:LEIGH
Last Name:WYROSDICK
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:LEIGH
Other - Last Name:GILMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 BAPTIST WAY STE 3A
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2274
Mailing Address - Country:US
Mailing Address - Phone:448-227-6604
Mailing Address - Fax:
Practice Address - Street 1:125 BAPTIST WAY STE 3A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2274
Practice Address - Country:US
Practice Address - Phone:448-227-6604
Practice Address - Fax:850-857-1747
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001465363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner