Individual
JUSTIN RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
3175 SMITH RD, LAMBERTVILLE, MI 48144-9434
(734) 856-5494
Mailing address
3175 SMITH RD, LAMBERTVILLE, MI 48144-9434
(734) 856-5494
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704350098
MI
163W00000X
Registered Nurse
RN.404739
OH
363LF0000X
Family Nurse Practitioner
Primary
4704350098
MI
Other
Enumeration date
06/09/2020
Last updated
11/03/2023
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