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1770123804
TAYSHA MARIE RYAN
CHAMPAIGN, IL
NPI
1770123804
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209020376)
Enumeration Date
2020-01-07
Last Update Date
2022-08-04
Business Address
TAYSHA MARIE RYAN
309 W CLARK ST
CHAMPAIGN, IL 61820-4637
Phone number: 217-398-9066
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Mailing Address
TAYSHA MARIE RYAN
309 W CLARK ST
CHAMPAIGN, IL 61820-4637
Phone number: 217-398-9066
Copy
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