Provider Demographics
NPI:1821606195
Name:RYAN, EMILY LYNN (DNP CNM)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:LYNN
Last Name:RYAN
Suffix:
Gender:F
Credentials:DNP CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 EVERGREEN TER
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:CT
Mailing Address - Zip Code:06483-3051
Mailing Address - Country:US
Mailing Address - Phone:203-619-3227
Mailing Address - Fax:
Practice Address - Street 1:60 WESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2460
Practice Address - Country:US
Practice Address - Phone:203-578-4609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCNM06507176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife