Mr. Ryan Eugene Parnham
Nurse Practitioner - Family Medicine
530 Ne Glen Oak Ave Suite 108
Peoria
, Illinois 61537-3167
Mr. Ryan Eugene Parnham
Nurse Practitioner - Family Medicine
530 Ne Glen Oak Ave Suite 108
Peoria
, Illinois 61537-3167
(309) 624-8818
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Mr. Ryan Eugene Parnham
- 530 Ne Glen Oak Ave Suite 108
- Peoria, IL
- Zip : 61537-3167
- Phone : (309) 624-8818
Second Address
- Mr. Ryan Eugene Parnham
- 530 Ne Glen Oak Ave Suite 108
- Peoria, IL
- Zip : 61537-3167
- Phone : (309) 624-8818
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 209006653 | IL |
National Provider Identifier
| NPI | 1003015447 |
|---|---|
| Provider Name | Mr. Ryan Eugene Parnham |
| First Address | Peoria, IL 61537-3167 |
| Second Address | Peoria, IL 61537-3167 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/07/2007 |
| Last Update Date | 17/03/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 809840 | MEDICARE GROUP NUMBER (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.