Provider Demographics
NPI:1356132047
Name:ANDRINGA, RYAN B (FNP-C)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:B
Last Name:ANDRINGA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 KIBBY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-4966
Mailing Address - Country:US
Mailing Address - Phone:616-403-4450
Mailing Address - Fax:
Practice Address - Street 1:900 E MICHIGAN AVE STE 105
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2490
Practice Address - Country:US
Practice Address - Phone:616-403-4450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF02250982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily