Individual
MARY KATHERINE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
775 POPLAR RD STE 310, NEWNAN, GA 30265-8303
(770) 251-2590
(404) 477-1162
Mailing address
1800 HOWELL MILL RD NW STE 800, ATLANTA, GA 30318-0922
(404) 350-9853
(404) 477-1162
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
272967
NC
363LA2200X
Adult Health Nurse Practitioner
COA.15224-NP
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
RN248115
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5007170
NCBON
NC
01
—
COA.15224-NP
CNP
OH
Enumeration date
10/24/2013
Last updated
04/14/2020
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