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General NPI Number Information
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NPI Number | 1871225789
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Entity Type | Individual
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Provider Name | RYAN SHERIDAN NP
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Gender | Male
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 1629 K ST NW STE 300
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City | WASHINGTON
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State | DC
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Zip | 20006-1631
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Country | US
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Telephone | 202-640-5502
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Fax | 202-810-9175
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Provider Business Mailing Address
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Address Line | 1629 K ST NW STE 300
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City | WASHINGTON
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State | DC
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Zip | 20006-1631
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP1057075
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2020003397
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN1057075
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License Number State | DC
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