| Doctor Name: | MS. STEPHANIE ELLEN RYAN |
| NPI Number: | 1780646489 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP, CDE |
| License Number: | |
| Business Practice Address: | 7166 Waterman Ave University City, MO - 631304325 |
| Business Phone Number: | 3146524100 |
| Business Fax Number: | 3142896478 |
| Mailing Address: | 7166 Waterman Ave, UNIVERSITY CITY |
| State: | MO |
| Postal Code: | 631304325 |
| Phone Number: | 3146524100 |
| Fax Number: | 3142896478 |
| NPI Enumeration Date: | 04/06/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |