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NPI Code Detail

MEDICARE: MR. RYAN A NIES

MEDICARE: MR. RYAN A NIES
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
1106H00000XMarriage & Family Therapist00002291CO
2106H00000XMarriage & Family Therapist203345TX

General Provider Information

NPI Number : 1942778840
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYAN A NIES
Provider Business Mailing Address
First Line : 6245 ASHRIDGE CT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80922-2107
Country : US
Telephone Number : 469-288-2144
Fax Number :
Provider Business Practice Location Address
First Line : 2020 N ACADEMY BLVD STE 200
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-1568
Country : US
Telephone Number : 719-623-2356
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2018
Last Update Date : 02/14/2023

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