NPI 1003814849

Ryan J Nettles, PAC

Practitioner Physician Assistant Leawood, KS

Practice location

Address: 3651 College Blvd #100a, Leawood, KS 66211-1904
Phone: (913) 319-7546
Fax: (913) 319-7691

Registered specialties (3)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA-2940 (CO)

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Registry record

NPI: 1003814849
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Jul 2005
Record last updated: 6 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.