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NPI Code Detail

MEDICARE: JENNIFER RYAN APNP

MEDICARE:   JENNIFER  RYAN  APNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner7217-33WI
2363LG0600XGerontology Nurse Practitioner7217-33WI
3363LP2300XPrimary Care Nurse Practitioner7217-33WI

General Provider Information

NPI Number : 1679023279
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER RYAN APNP
Provider Business Mailing Address
First Line : PO BOX 14017
Second Line :
City : MADISON
State : WI
Zip : 53708-0017
Country : US
Telephone Number : 608-240-0020
Fax Number : 608-245-3077
Provider Business Practice Location Address
First Line : 1617 SHERMAN AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-5930
Country : US
Telephone Number : 608-240-0020
Fax Number : 608-245-3077
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2016
Last Update Date : 10/06/2016

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