Provider Demographics
NPI:1285219014
Name:VANBUREN, JAMES RYAN (APRN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RYAN
Last Name:VANBUREN
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 1:7 TARRYALL TER
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-1527
Mailing Address - Country:US
Mailing Address - Phone:518-657-9345
Mailing Address - Fax:
Practice Address - Street 1:7 TARRYALL TER
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-1527
Practice Address - Country:US
Practice Address - Phone:518-657-9345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV836588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily