Provider Demographics
NPI:1679199830
Name:RYAN, EMILY J (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:J
Last Name:RYAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 INGERSOLL AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-2711
Mailing Address - Country:US
Mailing Address - Phone:309-706-0623
Mailing Address - Fax:
Practice Address - Street 1:101 8TH ST SE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-1938
Practice Address - Country:US
Practice Address - Phone:515-967-2699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist