Healthcare Provider Details

I. General information

NPI: 1316304660
Provider Name (Legal Business Name): KRISTEN ALEXANDRIA ROFF FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN ALEXANDRIA SCHNITTKER

II. Dates (important events)

Enumeration Date: 01/18/2016
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6559 N WICKHAM RD STE C-105
MELBOURNE FL
32940-2052
US

IV. Provider business mailing address

801 YORK ST
MANITOWOC WI
54220-4630
US

V. Phone/Fax

Practice location:
  • Phone: 321-395-3298
  • Fax: 321-241-1161
Mailing address:
  • Phone: 920-663-9008
  • Fax: 920-684-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11025197
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: