NPI 1053747493

Kenneth C Ryan, APRN

Practitioner Nurse Practitioner Jacksonville Beach, FL

Practice location

Address: 1370 13th Ave S STE 215, Jacksonville Beach, FL 32250-3206
Phone: (904) 249-1041
Fax: (904) 249-9764
Mailing address: PO Box 41113, Jacksonville, FL 32203-1113

Registered specialties

Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X Licence APRN9367359 (FL)

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Registry record

NPI: 1053747493
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Sep 2013
Record last updated: 12 Feb 2019

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.