Healthcare Provider Details

I. General information

NPI: 1508314782
Provider Name (Legal Business Name): RYAN PRESCOTT PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2016
Last Update Date: 09/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 W MARKET ST
AKRON OH
44303-1406
US

IV. Provider business mailing address

611 W MARKET ST
AKRON OH
44303-1406
US

V. Phone/Fax

Practice location:
  • Phone: 330-996-4600
  • Fax:
Mailing address:
  • Phone: 330-996-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN.387351
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: