Provider Demographics
NPI:1629648431
Name:NOLAN, RYANN KAYLEIGH (PA-C)
Entity Type:Individual
Prefix:
First Name:RYANN
Middle Name:KAYLEIGH
Last Name:NOLAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LONGMEADOW RD
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3421
Mailing Address - Country:US
Mailing Address - Phone:781-801-3593
Mailing Address - Fax:
Practice Address - Street 1:987 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1652
Practice Address - Country:US
Practice Address - Phone:781-927-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant