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Individual
MICHAEL RYAN
Active
Individual
MICHAEL RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
596705
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3436990-01
WELLMED MEDICAID
TX
01
—
391321YLPS
WELLMED MEDICARE
TX
Enumeration date
07/23/2013
Last updated
10/18/2016
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