Healthcare Provider Details

I. General information

NPI: 1477394187
Provider Name (Legal Business Name): ERIN ELIZABETH RYAN MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W GERRELL CT
CARY NC
27511-5872
US

IV. Provider business mailing address

115 W GERRELL CT
CARY NC
27511-5872
US

V. Phone/Fax

Practice location:
  • Phone: 919-745-0748
  • Fax:
Mailing address:
  • Phone: 919-745-0748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN009096
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: