1114108263 NPI number — MRS. LINDA CHRISTINE RYAN MS

Table of content: MRS. LINDA CHRISTINE RYAN MS (NPI 1114108263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114108263 NPI number — MRS. LINDA CHRISTINE RYAN MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RYAN
Provider First Name:
LINDA
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RYAN
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1114108263
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13601 S US HIGHWAY 71
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRANDVIEW
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64030-3659
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-966-0338
Provider Business Mailing Address Fax Number:
816-966-1023

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13601 S US HIGHWAY 71
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRANDVIEW
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64030-3659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-966-0338
Provider Business Practice Location Address Fax Number:
816-966-1023
Provider Enumeration Date:
11/16/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TB0200X , with the licence number:  R0429 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC1900X , with the licence number: R0429 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TF0000X , with the licence number: R0429 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)