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NPI Code Detail

MEDICARE: DR. COURTNEY DANIELLE RYAN PHARMD

MEDICARE: DR. COURTNEY DANIELLE RYAN PHARMD
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
1183500000XPharmacist26025517AIN
2183500000XPharmacist017077KY
3183500000XPharmacistRPH.03234130-2OH

General Provider Information

NPI Number : 1366859076
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COURTNEY DANIELLE RYAN PHARMD
Provider Business Mailing Address
First Line : 4222 CHARLESTOWN RD
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-9567
Country : US
Telephone Number : 812-542-3810
Fax Number :
Provider Business Practice Location Address
First Line : 4222 CHARLESTOWN RD
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-9567
Country : US
Telephone Number : 812-542-3810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2014
Last Update Date : 07/14/2014

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