Provider Demographics
NPI:1356082739
Name:CONNLEY, RYAN A (APRN-CNP, PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:A
Last Name:CONNLEY
Suffix:
Gender:M
Credentials:APRN-CNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 EDALBERT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-7695
Mailing Address - Country:US
Mailing Address - Phone:513-741-3100
Mailing Address - Fax:513-741-5686
Practice Address - Street 1:274 SUTTON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-3521
Practice Address - Country:US
Practice Address - Phone:855-577-7284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1157554163WG0000X, 363LP0808X
OHRN.404365163WG0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice