Provider Demographics
NPI:1548602956
Name:TAPPIN, RYAN JEFFREY (RN)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:JEFFREY
Last Name:TAPPIN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 FEDERAL STREET
Mailing Address - Street 2:LAHEY DANVERS
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923
Mailing Address - Country:US
Mailing Address - Phone:978-774-0730
Mailing Address - Fax:978-750-0246
Practice Address - Street 1:5 FEDERAL STREET
Practice Address - Street 2:LAHEY DANVERS
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923
Practice Address - Country:US
Practice Address - Phone:978-774-0730
Practice Address - Fax:978-750-0246
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2277613363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110097192AMedicaid
MA110097192AMedicaid