Individual
MR. RYAN JACK PAUL FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
8401 PICARDY AVE, BATON ROUGE, LA 70809-3685
(225) 308-0247
(225) 308-0249
Mailing address
8401 PICARDY AVE, BATON ROUGE, LA 70809-3685
(225) 308-0247
(225) 308-0249
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200992
LA
Other
Enumeration date
11/25/2018
Last updated
08/25/2021
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