Tina Ryan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2015039022 Issued in MO

Practice address

1351 Jefferson St Ste 115
Washington, MO 63090-6449

Phone

(636) 202-9400

Fax

(636) 330-2363

NPI assigned

Oct 30, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1922470889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 JEFFERSON ST STE 115",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630906449",
            "telephone_number": "636-330-2363",
            "fax_number": "636-202-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 JEFFERSON ST STE 115",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630906449",
            "telephone_number": "636-202-9400",
            "fax_number": "636-330-2363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 N New Ballas Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631416844",
            "country_code": "US",
            "telephone_number": "314-432-4999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12800 Boenker Ln",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "63044",
            "country_code": "US",
            "telephone_number": "314-551-0388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "TINA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015039022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbie Ruether
• Gina Elizabeth Ruether, M.S.,CCC-SLP
• Brad Evan Rumancik, MD
• Kirstin Jenna Russell, PMHNP
• Sarah Ann Russell, AGACNP-BC
• Marie Bernice Sander, RN, ANP-BC
• Sanjay Ghosh PHD MD PC
• Sanjay Ghosh PHD MD PC
• Cheryl Collier Savage, LCSW
• Garry R Scarato, MD

• Family Nurse Practitioner in Washington, MO
• Providers in Washington, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.