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Individual
SHANNON LOUISE RYAN
Active
Individual
SHANNON LOUISE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
363A00000X
Physician Assistant
Primary
085011572
IL
363AM0700X
Medical Physician Assistant
5601011451
MI
Other
Enumeration date
12/28/2022
Last updated
06/24/2026
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