Provider Demographics
NPI:1386913762
Name:VAN RYZIN, CAROL ANN (NP)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:VAN RYZIN
Suffix:
Gender:F
Credentials:NP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:NIH CLINICAL CTR
Mailing Address - Street 2:BUILDING 10, CRC , ROOM 1-2742
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-451-0399
Mailing Address - Fax:301-480-3932
Practice Address - Street 1:NIH CLINICAL CTR
Practice Address - Street 2:BUILDING 10, CRC , ROOM 1-2742
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-451-0399
Practice Address - Fax:301-480-3932
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR134751363LP0200X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics