Individual
JANESA RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1445 NORTH AVE, SPEARFISH, SD 57783-1552
(605) 644-4170
Mailing address
893 OAK CREEK RD, ALADDIN, WY 82710-9724
(605) 641-7595
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP001586
SD
363LF0000X
Family Nurse Practitioner
CP001586
SD
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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