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Individual

MR. RYAN H BOOTHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP

Contact information

Practice address
500 W THOMAS RD STE 230, PHOENIX, AZ 85013-4245
(602) 406-9999
(602) 406-8099
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
226867
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125664
AZ
Enumeration date
10/28/2019
Last updated
01/26/2026
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