Provider Demographics
NPI:1215545082
Name:WOODMANSEE, RYAN A (APRN)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:A
Last Name:WOODMANSEE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10383 HAGEN RANCH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3782
Mailing Address - Country:US
Mailing Address - Phone:561-739-5252
Mailing Address - Fax:561-739-5255
Practice Address - Street 1:10383 HAGEN RANCH RD STE 100
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3782
Practice Address - Country:US
Practice Address - Phone:561-739-5252
Practice Address - Fax:561-739-5255
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11007661363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily