Ivan Regalado Rodriguez
Ivan Regalado Rodriguez is a Family Nurse Practitioner in Fortson, Georgia. Practices as a sole proprietor. Licensed in Florida and Georgia.
- Licensed in
- FL, GA
- In the registry since
- 2023
- Specialties on file
- 2
Practice location Address checks out
4614 Wisteria LnFortson, GA 31808-6986
Phone: (770) 882-1728
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Nurse Practitioner (primary) | Taxonomy 363LF0000X · Licence RN291972 (GA) |
|---|---|
| Family Nurse Practitioner | Taxonomy 363LF0000X · Licence APRN11025390 (FL) |
Record details
| NPI number | 1639871866 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | March 21, 2023 |
| Last updated in NPPES | October 12, 2025 |
| Certification date | October 12, 2025 |
| Mailing address | 4614 Wisteria Ln, Fortson, GA 31808-6986 |