Ryan, Mark Kenneth

Ryan, Mark Kenneth is an individual health care provider with primary practice located at 30549 Sussex Hwy , Laurel DE 19956-3891. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Ryan, Mark Kenneth can be contacted via phone (302) 715-5214.

Contact Information

Primary practice address
30549 Sussex Hwy Laurel DE 19956-3891
Phone: (302) 715-5214
Fax: (302) 628-6855
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AC000091 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AC000091 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X LG-0000752 Delaware

Profile Details

NPI number 1669447637
LBN Legal business name Ryan, Mark Kenneth
Credentials CRNP MSN
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2006
Last updated Feb 29th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669447637 NPPES
Maryland MEDICAID 403638700

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