Provider Demographics
NPI:1770474462
Name:RYAN, DEANNE M (RPH BSPHARM)
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:M
Last Name:RYAN
Suffix:
Gender:F
Credentials:RPH BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6631 E MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-6181
Mailing Address - Country:US
Mailing Address - Phone:480-440-5368
Mailing Address - Fax:480-573-1016
Practice Address - Street 1:6631 E MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-6181
Practice Address - Country:US
Practice Address - Phone:480-440-5368
Practice Address - Fax:480-573-1016
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS011503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist