Provider Demographics
NPI:1003041393
Name:RYAN, KRISTEN M (LPN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:M
Last Name:RYAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PHEASANT LN
Mailing Address - Street 2:
Mailing Address - City:ATKINSON
Mailing Address - State:NH
Mailing Address - Zip Code:03811-2326
Mailing Address - Country:US
Mailing Address - Phone:603-362-8230
Mailing Address - Fax:603-362-4621
Practice Address - Street 1:1 PHEASANT LN
Practice Address - Street 2:
Practice Address - City:ATKINSON
Practice Address - State:NH
Practice Address - Zip Code:03811-2326
Practice Address - Country:US
Practice Address - Phone:603-362-8230
Practice Address - Fax:603-362-4621
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA62964164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse