Provider Demographics
NPI:1851505788
Name:FINNIGAN-RYAN, KATHLEEN (MSN, RN, FNP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:FINNIGAN-RYAN
Suffix:
Gender:F
Credentials:MSN, RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4777 IMPERIAL AVE
Mailing Address - Street 2:LHS STUDENT HEALTH CENTER
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92113-2071
Mailing Address - Country:US
Mailing Address - Phone:619-266-6502
Mailing Address - Fax:
Practice Address - Street 1:4777 IMPERIAL AVE
Practice Address - Street 2:LHS STUDENT HEALTH CENTER
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-2071
Practice Address - Country:US
Practice Address - Phone:619-266-6502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16331363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1851505788OtherNPI