Provider Demographics
NPI:1033445127
Name:RYAN, TAMMY SUE (CD(DONA))
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:SUE
Last Name:RYAN
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 SUTTON PL
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3141
Mailing Address - Country:US
Mailing Address - Phone:563-505-3991
Mailing Address - Fax:
Practice Address - Street 1:1804 SUTTON PL
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3141
Practice Address - Country:US
Practice Address - Phone:563-505-3991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula