Provider Demographics
NPI:1043709488
Name:RYDER, NANCY LOUISE
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LOUISE
Last Name:RYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7496 ROUTE 442 HWY
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-7290
Mailing Address - Country:US
Mailing Address - Phone:570-546-5836
Mailing Address - Fax:
Practice Address - Street 1:7496 ROUTE 442 HWY
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-7290
Practice Address - Country:US
Practice Address - Phone:570-546-5836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH005014L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist