Provider Demographics
NPI:1528848801
Name:RYAN, HAILIE CHRISTINE
Entity type:Individual
Prefix:
First Name:HAILIE
Middle Name:CHRISTINE
Last Name:RYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9398 FM 1960
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:77535-5892
Mailing Address - Country:US
Mailing Address - Phone:936-402-8088
Mailing Address - Fax:
Practice Address - Street 1:9398 FM 1960
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TX
Practice Address - Zip Code:77535-5892
Practice Address - Country:US
Practice Address - Phone:936-402-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider