Provider Demographics
NPI:1780192237
Name:ANASTASI, RYAN (CRNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:ANASTASI
Suffix:
Gender:F
Credentials:CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 W CHESTER PIKE STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4877
Mailing Address - Country:US
Mailing Address - Phone:484-947-5177
Mailing Address - Fax:484-947-5197
Practice Address - Street 1:999 W CHESTER PIKE STE 102
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4877
Practice Address - Country:US
Practice Address - Phone:484-947-5177
Practice Address - Fax:484-947-5197
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018388363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1034793590002Medicaid