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NPI Code Detail

MEDICARE: DR. RYAN WANDLER DNP, PMHNP-BC

MEDICARE: DR. RYAN WANDLER DNP, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner293118AZ

General Provider Information

NPI Number : 1982388997
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN WANDLER DNP, PMHNP-BC
Provider Business Mailing Address
First Line : 20950 N TATUM BLVD STE 380
Second Line :
City : PHOENIX
State : AZ
Zip : 85050-4258
Country : US
Telephone Number : 480-626-7584
Fax Number : 602-325-2082
Provider Business Practice Location Address
First Line : 20950 N TATUM BLVD STE 380
Second Line :
City : PHOENIX
State : AZ
Zip : 85050-4258
Country : US
Telephone Number : 480-626-7584
Fax Number : 602-325-2082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2023
Last Update Date : 05/29/2026

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