Individual
JAMES RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 865-3151
Mailing address
4500 13TH ST, GULFPORT, MS 39501-2515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R598267
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03309548
—
MS
Enumeration date
10/25/2006
Last updated
07/08/2007
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