Provider Demographics
NPI:1568138543
Name:SANGER, RYENN LEE (RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:RYENN
Middle Name:LEE
Last Name:SANGER
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:RYENN
Other - Middle Name:LEE
Other - Last Name:BIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 668
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-225-1580
Mailing Address - Fax:
Practice Address - Street 1:1682 EMPIRE BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2198
Practice Address - Country:US
Practice Address - Phone:585-671-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348134363AM0700X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical