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General NPI Number Information
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NPI Number | 1477427268
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Entity Type | Individual
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Provider Name | KYLE GARRETT RYDER
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Gender | Male
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 2828 1ST AVE STE 510
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City | HUNTINGTON
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State | WV
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Zip | 25702-1236
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Country | US
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Telephone | 304-399-7548
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Fax |
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Provider Business Mailing Address
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Address Line | 1448 10TH AVE STE 304
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City | HUNTINGTON
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State | WV
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Zip | 25701-3579
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Country | US
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Telephone | 304-633-1363
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 124375
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License Number State | WV
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