Individual
AMY RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CRNP
Contact information
Practice address
401 N BROADWAY ST, BALTIMORE, MD 21287
(410) 502-7149
Mailing address
401 N BROADWAY ST, BALTIMORE, MD 21287-0019
(410) 502-7149
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R177867
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R177867
STATE LICENSE
MD
Enumeration date
03/16/2014
Last updated
08/08/2018
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