Healthcare Provider Details

I. General information

NPI: 1164407961
Provider Name (Legal Business Name): ROSALYN R REISCHMAN PHD, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S. NEWELL DRIVE
GAINESVILLE FL
32611
US

IV. Provider business mailing address

PO BOX 100197
GAINESVILLE FL
32610-0197
US

V. Phone/Fax

Practice location:
  • Phone: 904-244-5175
  • Fax: 904-244-3246
Mailing address:
  • Phone: 904-244-5175
  • Fax: 904-244-3246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number554532
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number554532
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: