Provider Demographics
NPI:1942807938
Name:RYAN, TERRY DIANE
Entity Type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:DIANE
Last Name:RYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-5201
Mailing Address - Country:US
Mailing Address - Phone:520-471-8379
Mailing Address - Fax:
Practice Address - Street 1:2803 E 8TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-5201
Practice Address - Country:US
Practice Address - Phone:520-471-8379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-03
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based