Provider Demographics
NPI:1952922502
Name:SEVERO, RYAN DENNIS (APRN)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:DENNIS
Last Name:SEVERO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8831 FOUNDERS SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-0733
Mailing Address - Country:US
Mailing Address - Phone:239-348-4221
Mailing Address - Fax:
Practice Address - Street 1:8831 FOUNDERS SQUARE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-0733
Practice Address - Country:US
Practice Address - Phone:239-348-4221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11007014363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily