Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9189413 | FL |
NPI | 1033606884 |
---|---|
Provider Name | Mrs. Reed Lloyd Ryan |
First Address | Orlando, FL 32891-0001 |
Second Address | Tampa, FL 33606-3603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2018 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
025002100 | (05) | FL |
JN079 | MEDICARE (01) | FL |
KHUJU | BLUE CROSS BLUE SHIELD (01) | FL |