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NPI Code Detail

MEDICARE: MICHAEL JOHN-PAUL RYAN APRN

MEDICARE:   MICHAEL JOHN-PAUL RYAN  APRN
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
1363LF0000XFamily Nurse Practitioner12933889-4405UT

General Provider Information

NPI Number : 1427865948
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL JOHN-PAUL RYAN APRN
Provider Business Mailing Address
First Line : 1414 E 4500 S
Second Line :
City : MILLCREEK
State : UT
Zip : 84117-4228
Country : US
Telephone Number : 385-299-0473
Fax Number :
Provider Business Practice Location Address
First Line : 1414 E 4500 S
Second Line :
City : MILLCREEK
State : UT
Zip : 84117-4228
Country : US
Telephone Number : 385-299-0473
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2024
Last Update Date : 12/17/2024

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Directions to “ MICHAEL JOHN-PAUL RYAN APRN” Practice Location

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