Healthcare Provider Details

I. General information

NPI: 1164201307
Provider Name (Legal Business Name): RYAN NEAL ADAMS BS, BSN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 S MULBERRY ST
MOUNT VERNON OH
43050-3331
US

IV. Provider business mailing address

840 CLUB DR
MOUNT VERNON OH
43050-4738
US

V. Phone/Fax

Practice location:
  • Phone: 740-326-1231
  • Fax:
Mailing address:
  • Phone: 937-768-8074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0041395
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.370826
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: