| Doctor Name: | TRINA E RYAN |
| NPI Number: | 1265859433 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 18589 |
| Business Practice Address: | 16860 Highland Dr Mc Kenzie, TN - 382011620 |
| Business Phone Number: | 7313930450 |
| Business Fax Number: | 7313930451 |
| Mailing Address: | 176 W University Pkwy Ste C, JACKSON |
| State: | TN |
| Postal Code: | 383051618 |
| Phone Number: | 7316606915 |
| Fax Number: | 7316684557 |
| NPI Enumeration Date: | 03/25/2014 |
| NPI Last Update Date: | 04/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 18589 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |