Healthcare Provider Details

I. General information

NPI: 1962385765
Provider Name (Legal Business Name): NATALIE ROSE RUGGIERI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 N MACARTHUR AVE
PANAMA CITY FL
32401-3636
US

IV. Provider business mailing address

504 N MACARTHUR AVE
PANAMA CITY FL
32401-3636
US

V. Phone/Fax

Practice location:
  • Phone: 850-769-2158
  • Fax: 850-785-9220
Mailing address:
  • Phone: 850-769-2158
  • Fax: 850-785-9220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11041103
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: