Healthcare Provider Details

I. General information

NPI: 1760860126
Provider Name (Legal Business Name): RYAN DANIEL RESS CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2015
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 LIBERTY AVE STE 252
PITTSBURGH PA
15224-2156
US

IV. Provider business mailing address

565 COAL VALLEY RD
JEFFERSON HILLS PA
15025-3703
US

V. Phone/Fax

Practice location:
  • Phone: 412-235-5830
  • Fax: 412-235-5833
Mailing address:
  • Phone: 412-359-3030
  • Fax: 412-359-3090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP033258
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP033258
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: