Provider Demographics
NPI:1346681301
Name:RODECAP, NANCY MARIE (ANP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:MARIE
Last Name:RODECAP
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 N ATLANTIC AVE # 343
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-3205
Mailing Address - Country:US
Mailing Address - Phone:386-481-7836
Mailing Address - Fax:332-279-4811
Practice Address - Street 1:2665 N ATLANTIC AVE # 343
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118-3205
Practice Address - Country:US
Practice Address - Phone:386-424-1584
Practice Address - Fax:386-410-4800
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004178363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201171240Medicaid
IN715320008Medicare PIN