Provider Demographics
NPI:1043550957
Name:PAULSEN, RYAN B (PHD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:B
Last Name:PAULSEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 GREAT CIRCLE RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1310
Mailing Address - Country:US
Mailing Address - Phone:615-425-4604
Mailing Address - Fax:615-255-3030
Practice Address - Street 1:515 GREAT CIRCLE RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1310
Practice Address - Country:US
Practice Address - Phone:615-425-4604
Practice Address - Fax:615-255-3030
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNML0000023336247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician