Provider Demographics
NPI:1558368068
Name:CARNAHAN, RYAN MICHAEL (PHARMD, MS, BCPP)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MICHAEL
Last Name:CARNAHAN
Suffix:
Gender:M
Credentials:PHARMD, MS, BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR.
Mailing Address - Street 2:C 21-H GH
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242
Mailing Address - Country:US
Mailing Address - Phone:319-384-5152
Mailing Address - Fax:319-384-5009
Practice Address - Street 1:200 HAWKINS DR.
Practice Address - Street 2:C 21-H GH
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-384-5152
Practice Address - Fax:319-384-5009
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK134931835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric