Provider Demographics
NPI:1922825439
Name:RHYAN, JORDAN LEIGH (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:LEIGH
Last Name:RHYAN
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 N MAIN ST
Mailing Address - Street 2:PO BOX 18
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:OH
Mailing Address - Zip Code:45349
Mailing Address - Country:US
Mailing Address - Phone:937-684-3804
Mailing Address - Fax:
Practice Address - Street 1:9049 N SPRINGBORO PK
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342
Practice Address - Country:US
Practice Address - Phone:937-759-0545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH414472363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty