Provider Demographics
NPI:1295576858
Name:RODDA, DENISE A (APRN)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:A
Last Name:RODDA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:A
Other - Last Name:NICKENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100108
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0108
Mailing Address - Country:US
Mailing Address - Phone:352-265-0535
Mailing Address - Fax:352-627-4173
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:522-650-5353
Practice Address - Fax:352-627-4173
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11033147363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care