Provider Demographics
NPI:1548743503
Name:PASHLEY, RYAN (FNP)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:PASHLEY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BOWMAN DR STE E385
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-9638
Mailing Address - Country:US
Mailing Address - Phone:856-840-2853
Mailing Address - Fax:856-762-2853
Practice Address - Street 1:200 BOWMAN DR STE E385
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9638
Practice Address - Country:US
Practice Address - Phone:856-840-2853
Practice Address - Fax:856-762-2853
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00828700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily