| Doctor Name: | MR. RYAN EUGENE PARNHAM |
| NPI Number: | 1003015447 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP-C |
| License Number: | 209006653 |
| Business Practice Address: | 530 Ne Glen Oak Ave Suite 108 Peoria, IL - 615373167 |
| Business Phone Number: | 3096248818 |
| Business Fax Number: | |
| Mailing Address: | 530 Ne Glen Oak Ave, Suite 108 PEORIA |
| State: | IL |
| Postal Code: | 615373167 |
| Phone Number: | 3096248818 |
| Fax Number: | |
| NPI Enumeration Date: | 07/16/2007 |
| NPI Last Update Date: | 03/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209006653 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |