Healthcare Provider Details

I. General information

NPI: 1407590037
Provider Name (Legal Business Name): BAYLEE ROLLING APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15551 NW US HIGHWAY 441 UNIT 40
ALACHUA FL
32615-9330
US

IV. Provider business mailing address

1702 S JEFFERSON ST
PERRY FL
32348-5611
US

V. Phone/Fax

Practice location:
  • Phone: 386-518-0102
  • Fax: 386-518-0116
Mailing address:
  • Phone: 855-577-5437
  • Fax: 850-838-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11036253
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-184483
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: