DR. RYAN FREDERICK THEEN (NPI# 1639424716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639424716 |
| Entity Type | Individual |
| Full Name | DR. RYAN FREDERICK THEEN |
| Credential | DC, MSN, APRN, FNP-C |
| Practice Address |
13861 Manchester Rd Manchester MO 63011-4503 |
| Practice Telephone | 6362209333 |
| Mailing Telephone | 6184448099 |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2020-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 08002660A | IN | Chiropractic Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
209021715 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2020028106 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
13861 MANCHESTER RD |
| City | MANCHESTER |
| State | MO |
| Zip Code | 63011-4503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659988533 | Mark Stephen Holder | Physician Assistant | 13861 Manchester Rd, Manchester, MO 63011-4503 | 2020-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205309234 | Heather Renee Leone | Nurse Practitioner | 452 Sovereign Court Suite A, Ballwin, MO 63011 | 2019-01-02 |
| 1538635297 | Jennifer Lea Nicole O'donnell | Registered Nurse | 13861 Manchester Road, Town and Country, MO 63011 | 2018-10-22 |
| 1285127712 | Genevieve Friedmann | Social Worker | 301 Sovereign Ct Ste 103, Ballwin, MO 63011 | 2018-06-09 |
| 1881187391 | Andrew Cittadino Link | Dentist | 14335 Manchester Road, Ballwin, MO 63011 | 2018-06-08 |
| 1972041283 | Anavan LLC | Durable Medical Equipment & Medical Supplies | 14390 Manchester Rd, Saint Louis, MO 63011 | 2017-02-07 |
| 1780131300 | Autism and Behavioral Spectrum LLC | Day Training, Developmentally Disabled Services | 14733 Clayton Road, Chesterfield, MO 63011 | 2016-09-01 |
| 1265872964 | Eryn Nichole Miner | Behavioral Analyst | 15834 Clayton Road, Ellisville, MO 63011 | 2013-06-27 |
| 1194168765 | Donna Margaret Carrillo | Developmental Therapist | 15834 Clayton Rd., Ellisville, MO 63011 | 2013-04-12 |
| 1891047486 | Ashley Amanda Battaglia | Chiropractor | 15945 Clayton Rd Ste 230c, Ballwin, MO 63011 | 2012-10-08 |
| 1750658480 | Gary Frank Sobocinski | Pharmacist | 4033 Sovereign Court, Ballwin, MO 63011 | 2011-11-23 |
| Find all providers in zip 63011 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553233 | Anylen Ruiz Ayala | Nurse Practitioner | 109 W Center St, Manchester, CT 06040-4917 | 2020-09-16 |
| 1497368146 | Sarah Kuzara | Nurse Practitioner | 1069 Big Bend Crossing Dr, Manchester, MO 63088-1296 | 2020-08-24 |
| 1265068910 | Katelyn Denise Walker | Nurse Practitioner | 306 Boone Dr, Manchester, TN 37355-7820 | 2020-03-13 |
| 1780219659 | Ashlynn Fogg | Nurse Practitioner | 1750 Elm St Ste 201a, Manchester, NH 03104-2903 | 2020-03-11 |
| 1922669357 | Heather Rogers Hansen | Nurse Practitioner | 1279 S Willow St Ste E, Manchester, NH 03103-4015 | 2019-06-26 |
| 1619433802 | Samantha Ashley Case | Nurse Practitioner | 635 Clay St Fl 1, Manchester, NH 03103-4507 | 2019-02-13 |
| 1538640420 | Isaac Okyere Ampofo | Nurse Practitioner | 629 Middle Turnpike East, Manchester, CT 06040-3571 | 2018-08-28 |
| 1730675562 | Hannah E Boutselis | Nurse Practitioner | 1750 Elm St., Suite 201a, Manchester, NH 03104 | 2018-07-04 |
| 1952817371 | Rodrick Emmanuel Thomas | Nurse Practitioner | 553 S Commercial St Apt 309, Manchester, NH 03101-2749 | 2017-12-20 |
| 1063950160 | Kacy Mikala Kirk | Nurse Practitioner | 183 Roberts Creek Cir, Manchester, TN 37355-3690 | 2017-02-08 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 63011 |
Please comment or provide details below to improve the information on DR. RYAN FREDERICK THEEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.