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Individual
SUNY ROMAN
Active
Individual
SUNY ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
APRN11026019
FL
363LF0000X
Family Nurse Practitioner
Primary
APRN11026019
FL
363LP2300X
Primary Care Nurse Practitioner
11026019
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126244700
—
FL
Enumeration date
05/03/2023
Last updated
12/01/2025
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