Individual
MR. MARK KENNETH RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP MSN
Contact information
Practice address
30549 SUSSEX HWY, LAUREL, DE 19956-3891
(302) 715-5214
(302) 628-6855
Mailing address
30549 SUSSEX HWY, LAUREL, DE 19956-3891
(302) 715-5214
(302) 628-6855
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AC000091
MD
363LF0000X
Family Nurse Practitioner
Primary
LG-0000752
DE
367500000X
Certified Registered Nurse Anesthetist
AC000091
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403638700
—
MD
Enumeration date
02/22/2006
Last updated
02/29/2016
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