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NPI Code Detail

MEDICARE: MEGAN RENEE RYAN

MEDICARE: MEGAN RENEE RYAN
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
1163W00000XRegistered NurseRN9526389FL

General Provider Information

NPI Number : 1407486889
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN RENEE RYAN
Provider Business Mailing Address
First Line : 4300 SW 13TH ST
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-4006
Country : US
Telephone Number : 352-374-5600
Fax Number :
Provider Business Practice Location Address
First Line : 10 W MAIN ST
Second Line :
City : LAKE BUTLER
State : FL
Zip : 32054-1638
Country : US
Telephone Number : 386-496-2347
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2020
Last Update Date : 01/24/2020

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Directions to “ MEGAN RENEE RYAN ” Practice Location

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