MEDICARE: RYAN JAMES BRISTOL APRN, FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	842849	NV
2	163WE0003X	Emergency Registered Nurse	RN97847	NV

General Provider Information

NPI Number	:	1013597756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN JAMES BRISTOL APRN, FNP

Provider Business Mailing Address
First Line	:	3650 MAYBERRY DR STE 102
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-2131
Country	:	US
Telephone Number	:	775-343-6293
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 MAYBERRY DR STE 102
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-2131
Country	:	US
Telephone Number	:	775-343-6293
Fax Number	:	775-227-8342

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2021
Last Update Date	:	02/12/2026

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