=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932074671
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RHYAN MCFANN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2025
-----------------------------------------------------
Last Update Date | 10/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17273 STATE ROUTE 104
-----------------------------------------------------
City | CHILLICOTHEE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45601-9718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-698-4211
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10159 STATE ROUTE 93
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45640-9748
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number | 190583
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------