Provider Demographics
NPI:1316221096
Name:RYAN, ERIN K (MS)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:RYAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7065 W ANN RD # 403-671
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3865
Mailing Address - Country:US
Mailing Address - Phone:702-595-5437
Mailing Address - Fax:702-425-2787
Practice Address - Street 1:7495 W AZURE DR STE 254
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-4416
Practice Address - Country:US
Practice Address - Phone:702-595-5437
Practice Address - Fax:702-425-2787
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0000082376171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator