Individual
AMANDA LEIGH RUYLE-RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
3132 OLD JACKSONVILLE RD STE 200, SPRINGFIELD, IL 62704-7401
(217) 862-0800
(217) 862-0871
Mailing address
3132 OLD JACKSONVILLE RD STE 200, SPRINGFIELD, IL 62704-7401
(217) 862-0800
(217) 862-0871
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
209020475
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
277001660
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041403381
RN LICENSE
IL
Enumeration date
03/18/2020
Last updated
12/30/2024
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