Doctor Name: | JUDITH W. RYAN |
NPI Number: | 1043220593 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | R051691 |
Business Practice Address: | 10989 Red Run Blvd Suite 208 Owings Mills, MD - 211173283 |
Business Phone Number: | 4106548602 |
Business Fax Number: | 4106548709 |
Mailing Address: | 1514 Woodside Ave, BALTIMORE |
State: | MD |
Postal Code: | 212274038 |
Phone Number: | 4106548602 |
Fax Number: | 4106548709 |
NPI Enumeration Date: | 08/08/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | R051691 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |