Provider Demographics
NPI:1336522630
Name:CODNER, RYAN (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:CODNER
Suffix:
Gender:M
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18181 PEARL ROAD
Mailing Address - Street 2:SUITE A200
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-6953
Mailing Address - Country:US
Mailing Address - Phone:440-816-4950
Mailing Address - Fax:440-816-4960
Practice Address - Street 1:18181 PEARL ROAD
Practice Address - Street 2:SUITE A200
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6953
Practice Address - Country:US
Practice Address - Phone:440-816-4950
Practice Address - Fax:440-816-4960
Is Sole Proprietor?:No
Enumeration Date:2015-07-06
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17377-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics