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General NPI Number Information
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NPI Number | 1013729292
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Entity Type | Individual
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Provider Name | RYAN KERR
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Gender | Male
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 300 TIJERAS AVE NE APT 312
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-4484
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Country | US
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Telephone | 703-674-7064
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Fax |
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Provider Business Mailing Address
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Address Line | 300 TIJERAS AVE NE APT 312
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-4484
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP61596679
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 80410
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License Number State | NM
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