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General NPI Number Information
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NPI Number | 1801501630
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Entity Type | Individual
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Provider Name | RYAN DAGUE DNP FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 4701 INTERNATIONAL BLVD
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City | WILSON
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State | NC
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Zip | 27893-9664
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Country | US
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Telephone | 252-265-1957
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Fax |
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Provider Business Mailing Address
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Address Line | 4701 INTERNATIONAL BLVD
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City | WILSON
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State | NC
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Zip | 27893-9664
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.27251
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN275020
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5022226
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License Number State | NC
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