Provider Demographics
NPI:1558983759
Name:RYAN, CLAIRE NICOLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:NICOLE
Last Name:RYAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:CLAIRE
Other - Middle Name:NICOLE
Other - Last Name:SOTIRIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7309 BANNOCKBURN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-5618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3307
Practice Address - Country:US
Practice Address - Phone:703-776-3657
Practice Address - Fax:703-776-2623
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024179818367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered