Provider Demographics
NPI:1366001885
Name:KERRINS, RYAN B (DNP, FNP-BC, CCRN)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:B
Last Name:KERRINS
Suffix:
Gender:M
Credentials:DNP, FNP-BC, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 N RACE ST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-3483
Mailing Address - Country:US
Mailing Address - Phone:270-651-4444
Mailing Address - Fax:270-651-4892
Practice Address - Street 1:1301 N RACE ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3483
Practice Address - Country:US
Practice Address - Phone:270-651-4444
Practice Address - Fax:270-651-4892
Is Sole Proprietor?:No
Enumeration Date:2019-06-08
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25921363LF0000X
KY3013741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100615640Medicaid