Basic Information
| Provider Information | |||||||||
| NPI: | 1801211511 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RYAN | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | I | ||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 N HIGH ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432012460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142996600 | ||||||||
| FaxNumber: | 6144213111 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 N HIGH ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432012460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142996600 | ||||||||
| FaxNumber: | 6144213111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2014 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN-199802 | OH | N | Nursing Service Providers | Registered Nurse | 363LP0808X | CNP.021052 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.