Individual
MR. RYAN OMALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, MSN, AGACNP
Contact information
Practice address
200 BOWMAN DR, SUITE 355, VOORHEES, NJ 08043-9623
(865) 247-7210
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ00646800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0547841
—
NJ
Enumeration date
03/02/2016
Last updated
10/30/2024
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