Provider Demographics
NPI:1891550422
Name:ROCKWELL, RYLEY (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:RYLEY
Middle Name:
Last Name:ROCKWELL
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 WINTER GARDEN VINELAND RD
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6098
Mailing Address - Country:US
Mailing Address - Phone:407-629-2444
Mailing Address - Fax:
Practice Address - Street 1:5151 WINTER GARDEN VINELAND RD
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6098
Practice Address - Country:US
Practice Address - Phone:407-629-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031006363L00000X
FLAPRN11031006363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner