Basic Information
| Provider Information | |||||||||
| NPI: | 1447921440 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RYAN | ||||||||
| FirstName: | BRITTANY | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2678 RIDGE DR | ||||||||
| Address2: | |||||||||
| City: | HIGH RIDGE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630492324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149546781 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1015 BOWLES AVE | ||||||||
| Address2: | |||||||||
| City: | FENTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630262394 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6364962000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2021 | ||||||||
| LastUpdateDate: | 09/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | 2010031591 | MO | Y | Nursing Service Providers | Registered Nurse | Critical Care Medicine |
No ID Information.