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General NPI Number Information
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NPI Number | 1982411856
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Entity Type | Organization
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Legal Business Name | KAILEN B RYAN PMHNP-BC
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Dates
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Enumeration Date | 12/14/2024
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Last Update Date | 12/14/2024
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Provider Practice Location Address
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Address Line | 243 MAIN ST
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City | BUZZARDS BAY
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State | MA
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Zip | 02532-3229
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Country | US
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Telephone | 508-743-5542
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Fax |
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Provider Business Mailing Address
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Address Line | 27 MOUNT PLEASANT ST
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City | PLYMOUTH
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State | MA
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Zip | 02360-2904
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Country | US
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Telephone | 413-475-2535
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Fax |
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Authorized Official
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Title or Position | RMHNP
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Name | KAILEN B RYAN
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Credential |
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Telephone | 413-475-2535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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