Basic Information
| Provider Information | |||||||||
| NPI: | 1972700748 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NERLAND | ||||||||
| FirstName: | RYAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 400 | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383020400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7314238697 | ||||||||
| FaxNumber: | 7314255783 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 GARRETT DR | ||||||||
| Address2: | |||||||||
| City: | MEDINA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383559641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7314220355 | ||||||||
| FaxNumber: | 7314220354 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2007 | ||||||||
| LastUpdateDate: | 11/25/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 51457 | TN | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 51457 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.