MEDICARE: MELINDA KAY RYAN FNP

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	1108224	TX

General Provider Information

NPI Number	:	1457050353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA KAY RYAN FNP

Provider Business Mailing Address
First Line	:	1018 SPEEGLE ST
Second Line	:
City	:	TAYLOR
State	:	TX
Zip	:	76574-2658
Country	:	US
Telephone Number	:	512-914-2865
Fax Number	:	512-532-6055

Provider Business Practice Location Address
First Line	:	306 E MAIN ST STE 104
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-5220
Country	:	US
Telephone Number	:	512-774-4685
Fax Number	:	512-549-7641

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

Provider Enumeration Date	:	02/28/2023
Last Update Date	:	05/26/2026

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