Provider Demographics
NPI:1982411856
Name:KAILEN B RYAN PMHNP-BC
Entity type:Organization
Organization Name:KAILEN B RYAN PMHNP-BC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RMHNP
Authorized Official - Prefix:
Authorized Official - First Name:KAILEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-475-2535
Mailing Address - Street 1:27 MOUNT PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2904
Mailing Address - Country:US
Mailing Address - Phone:413-475-2535
Mailing Address - Fax:
Practice Address - Street 1:243 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUZZARDS BAY
Practice Address - State:MA
Practice Address - Zip Code:02532-3229
Practice Address - Country:US
Practice Address - Phone:508-743-5542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty