Individual
MISS JEAN M RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Contact information
Practice address
1204 HIGHWAY 60 # 1009, SOCORRO, NM 87801-3914
(575) 838-3690
(575) 838-4689
Mailing address
PO BOX 1009, SOCORRO, NM 87801-1009
(575) 838-4690
(575) 838-2380
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R37016
NM
163W00000X
Registered Nurse
RN00056320
WA
163WG0000X
General Practice Registered Nurse
081000105RN
OR
363LF0000X
Family Nurse Practitioner
200250125NP FNP-PP
OR
363LF0000X
Family Nurse Practitioner
AP60004124
WA
363LF0000X
Family Nurse Practitioner
Primary
CNP00802
NM
Other
Enumeration date
11/23/2005
Last updated
08/14/2013
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