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General NPI Number Information
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NPI Number | 1285825208
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Entity Type | Individual
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Provider Name | BRANDON RYAN PA-C, NREMT-P
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Gender | Male
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1705 GARDNER RD
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City | WILMINGTON
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State | NC
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Zip | 28405-8873
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Country | US
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Telephone | 910-343-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 1705 GARDNER RD
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City | WILMINGTON
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State | NC
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Zip | 28405-8873
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Country | US
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Telephone | 910-343-5300
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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 | 146L00000X
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Taxonomy Name | Paramedic
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License Number | P071746
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | 6611
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA06145
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-01834
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-01834
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License Number State | NC
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