MEDICARE: KATHLEEN FINNIGAN-RYAN MSN, RN, FNP

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
1	363LP2300X	Primary Care Nurse Practitioner	16331	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1851505788	OTHER		NPI

General Provider Information

NPI Number	:	1851505788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN FINNIGAN-RYAN MSN, RN, FNP

Provider Business Mailing Address
First Line	:	4777 IMPERIAL AVE
Second Line	:	LHS STUDENT HEALTH CENTER
City	:	SAN DIEGO
State	:	CA
Zip	:	92113-2071
Country	:	US
Telephone Number	:	619-266-6502
Fax Number	:

Provider Business Practice Location Address
First Line	:	4777 IMPERIAL AVE
Second Line	:	LHS STUDENT HEALTH CENTER
City	:	SAN DIEGO
State	:	CA
Zip	:	92113-2071
Country	:	US
Telephone Number	:	619-266-6502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/11/2013

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