MEDICARE: TERESA ANN RYAN NP

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	AP10753	AZ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	C-RXN.0103544-C-NP	CO
3	363LF0000X	Family Nurse Practitioner	95002231	CA
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	C-APN.0105234-C-NP	CO
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP10753	AZ

General Provider Information

NPI Number	:	1073650305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA ANN RYAN NP

Provider Business Mailing Address
First Line	:	9015 W UNION HILLS DR STE 107-559
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-3106
Country	:	US
Telephone Number	:	928-569-3238
Fax Number	:	480-900-8597

Provider Business Practice Location Address
First Line	:	9015 W UNION HILLS DR STE 107-559
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-3106
Country	:	US
Telephone Number	:	928-569-3238
Fax Number	:	480-900-8597

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	01/16/2026

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