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General NPI Number Information
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NPI Number | 1235706250
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Entity Type | Individual
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Provider Name | RYAN ERNEST RN
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Gender | Male
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 4801 COX RD STE 205
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6803
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Country | US
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Telephone | 804-796-0790
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Fax | 804-796-0799
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Provider Business Mailing Address
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Address Line | 4801 COX RD STE 205
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6803
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Country | US
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Telephone | 804-796-0790
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Fax | 804-796-0799
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 0001251821
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0024182462
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024182462
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License Number State | VA
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