Provider Demographics
NPI:1285843045
Name:SUZANNE RYAN MIDWIFERY SERVICES
Entity type:Organization
Organization Name:SUZANNE RYAN MIDWIFERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNM, WHCNP
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:913-547-1495
Mailing Address - Street 1:111 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-2601
Mailing Address - Country:US
Mailing Address - Phone:913-547-1495
Mailing Address - Fax:866-885-9694
Practice Address - Street 1:111 S 5TH ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-2601
Practice Address - Country:US
Practice Address - Phone:913-547-1495
Practice Address - Fax:866-885-9694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000162927367A00000X
KS64060367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty