Individual
MEREDITH COLEY RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
285 BAMA WAY, WILLISTON, TN 38076-6153
(817) 253-7605
Mailing address
285 BAMA WAY, WILLISTON, TN 38076-6153
(817) 253-7605
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02904
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3494
PHYSICIAN ASSISTANT LICENSE
TN
01
—
5608
PHYSICIAN ASSISTANT LICENSE
AZ
01
—
PA 02904
PHYSICIAN ASSISTANT LICENSE
TX
Enumeration date
08/11/2006
Last updated
07/10/2025
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