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General NPI Number Information
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NPI Number | 1588442719
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Entity Type | Individual
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Provider Name | LINDSAY MICHELLE RYAN FNP-C, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 13570 N MAIN ST
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City | TRENTON
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State | GA
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Zip | 30752-2012
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Country | US
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Telephone | 706-956-2665
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Fax |
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Provider Business Mailing Address
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Address Line | 13570 N MAIN ST
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City | TRENTON
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State | GA
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Zip | 30752-2012
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Country | US
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Telephone | 706-956-2665
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN205804
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | LC000160
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License Number State | GA
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