Provider Demographics
NPI:1316062409
Name:KROSER, RYAN AUSBROOKS (FNP)
Entity type:Individual
Prefix:MRS
First Name:RYAN
Middle Name:AUSBROOKS
Last Name:KROSER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:RYAN
Other - Middle Name:AUSBROOKS
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 1017
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-1017
Mailing Address - Country:US
Mailing Address - Phone:615-289-3297
Mailing Address - Fax:
Practice Address - Street 1:608 COMMONS DR
Practice Address - Street 2:SUITE A
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-6349
Practice Address - Country:US
Practice Address - Phone:615-452-5901
Practice Address - Fax:615-451-2006
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN12208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN12208OtherFNP LICENSE
TNAPN12208OtherFNP LICENSE