Individual
KRISTI N RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-AC
Contact information
Practice address
420 NE GLEN OAK AVE, SUITE 301, PEORIA, IL 61603-3105
(309) 655-3453
(309) 655-3410
Mailing address
420 NE GLEN OAK AVE, SUITE 301, PEORIA, IL 61603-3105
(309) 655-3453
(309) 655-3410
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
198953
NC
363L00000X
Nurse Practitioner
Primary
209-012284
IL
Other
Enumeration date
03/30/2010
Last updated
04/30/2015
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