Provider Demographics
NPI:1912428798
Name:RYAN, JAMI LYNN (FNP)
Entity type:Individual
Prefix:
First Name:JAMI
Middle Name:LYNN
Last Name:RYAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 SW AVERY ST
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-6351
Mailing Address - Country:US
Mailing Address - Phone:765-606-6783
Mailing Address - Fax:
Practice Address - Street 1:1315 N ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-3204
Practice Address - Country:US
Practice Address - Phone:317-762-0190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28164946A163W00000X
OR201703152NP-PP363LF0000X
IN71009593B363LF0000X
IN71009593A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse