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NPI Code Detail

MEDICARE: RYAN CARROLL CRNP

MEDICARE: RYAN CARROLL CRNP
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
1363L00000XNurse PractitionerSP017551PA

General Provider Information

NPI Number : 1225566409
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN CARROLL CRNP
Provider Business Mailing Address
First Line : 400 MOSITES WAY STE 401
Second Line :
City : PITTSBURGH
State : PA
Zip : 15205-1342
Country : US
Telephone Number : 445-300-7197
Fax Number :
Provider Business Practice Location Address
First Line : 400 MOSITES WAY STE 401
Second Line :
City : PITTSBURGH
State : PA
Zip : 15205-1342
Country : US
Telephone Number : 855-706-5387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2017
Last Update Date : 12/29/2023

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