Individual
SHANNON C RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
312 OAK ST, STE 205, CENTRAL POINT, OR 97502-2542
(541) 727-7787
(541) 727-7529
Mailing address
312 OAK ST, STE 205, CENTRAL POINT, OR 97502-2542
(541) 727-7787
(541) 727-7529
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
099000570RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201600527NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16
—
OR
05
—
163WC1500X
—
OR
Enumeration date
09/08/2011
Last updated
06/17/2020
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