Individual provider Active NPI

Kathleen Ryan, APN

  • Adult Health Nurse Practitioner
  • Fort Polk, LA
National Provider Identifier
1245372622
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
254355 Issued in TX
Practice address
6907 Ellis CT Apt C
6907 C
Fort Polk, LA 71459-3123
Phone
(337) 281-1040
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 254355 TX Primary
Family Nurse Practitioner 363LF0000X 254355 TX

Addresses

Primary practice location

6907 Ellis CT Apt C
6907 C
Fort Polk, LA 71459-3123

Mailing address

6907 Ellis CT Apt C
6907 C
Fort Polk, LA 71459-3123
Phone (337) 281-1040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
254355TXMDAdult Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1245372622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6907 ELLIS CT APT C",
            "address_2": "6907 C",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714593123",
            "telephone_number": "337-281-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6907 ELLIS CT APT C",
            "address_2": "6907 C",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714593123",
            "telephone_number": "337-281-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KATHLEEN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "254355",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "254355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Polk, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.