Individual
MRS. RYAN JESSUP O'LEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6401 STARGAZE LN, CHARLOTTE, NC 28269-0802
(704) 591-7196
(704) 464-1818
Mailing address
17104 PENNINGTON DR, HUNTERSVILLE, NC 28078-4854
(704) 995-2249
(980) 689-5076
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
200201293
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89133J6
—
NC
Enumeration date
10/27/2006
Last updated
04/16/2018
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