Provider Demographics
NPI:1770367005
Name:RYALS, ERIN ROBERTS (APRN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ROBERTS
Last Name:RYALS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MICHELLE
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1812 W INDIANHEAD DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-4745
Mailing Address - Country:US
Mailing Address - Phone:850-544-2973
Mailing Address - Fax:
Practice Address - Street 1:1803 MICCOSUKEE COMMONS DR STE 101
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7403
Practice Address - Country:US
Practice Address - Phone:850-297-0114
Practice Address - Fax:850-297-0314
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11028144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily