Healthcare Provider Details

I. General information

NPI: 1972993046
Provider Name (Legal Business Name): LORI SKYE RYAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2015
Last Update Date: 01/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31667 MAPLE CT
LEWES DE
19958-2048
US

IV. Provider business mailing address

31667 MAPLE CT
LEWES DE
19958-2048
US

V. Phone/Fax

Practice location:
  • Phone: 302-588-2588
  • Fax:
Mailing address:
  • Phone: 302-588-2588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberR128429
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: