Provider Demographics
NPI:1083021919
Name:TREAT, RYAN (FNP)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:TREAT
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:MR
Other - First Name:RYAN
Other - Middle Name:
Other - Last Name:TREAT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:18001 N 79TH AVE STE D69
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8395
Mailing Address - Country:US
Mailing Address - Phone:623-486-8378
Mailing Address - Fax:623-486-0858
Practice Address - Street 1:18001 N 79TH AVE STE D69
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8395
Practice Address - Country:US
Practice Address - Phone:623-486-8378
Practice Address - Fax:623-486-0858
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP5681363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily