Provider Demographics
NPI:1982388997
Name:WANDLER, RYAN (DNP, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:WANDLER
Suffix:
Gender:M
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 S ARIZONA AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-2717
Mailing Address - Country:US
Mailing Address - Phone:480-923-6340
Mailing Address - Fax:602-325-2082
Practice Address - Street 1:3033 S ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-2717
Practice Address - Country:US
Practice Address - Phone:480-923-6340
Practice Address - Fax:602-325-2082
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ293118363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health