Kellie Marie Ryan - Wilson, CNM | |
220 E. Harris, San Angelo, TX 76903 | |
(325) 658-1511 | |
(325) 481-2165 |
Full Name | Kellie Marie Ryan - Wilson |
---|---|
Gender | Female |
Speciality | Certified Nurse Midwife (cnm) |
Experience | 22 Years |
Location | 220 E. Harris, San Angelo, Texas |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255393872 | NPI | - | NPPES |
170388603 | Medicaid | TX | |
8Y3124 | Other | TX | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LW0102X | Nurse Practitioner - Women's Health | AP111628 (Texas) | Secondary |
367A00000X | Advanced Practice Midwife | AP111628 (Texas) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Shannon Medical Center | San angelo, TX | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Shannon Clinic | 0840103727 | 411 |
Entity Name | Shannon Clinic |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770587149 PECOS PAC ID: 0840103727 Enrollment ID: O20031222000702 |
Mailing Address | Practice Location Address |
---|---|
Kellie Marie Ryan - Wilson, CNM Po Box 22000, San Angelo, TX 76902-7200 Ph: (325) 658-1511 | Kellie Marie Ryan - Wilson, CNM 220 E. Harris, San Angelo, TX 76903 Ph: (325) 658-1511 |
Kelsey Danielle Walts, Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 3501 Knickerbocker Rd, San Angelo, TX 76904 Phone: 325-747-3408 Fax: 325-747-2525 | |
Cynthia Stokes, RN, MSN, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 1610 S Chadbourne St, San Angelo, TX 76903 Phone: 325-658-5339 Fax: 325-659-8534 | |
Christina Arp, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 220 E. Harris, San Angelo, TX 76903 Phone: 325-481-2285 Fax: 325-481-2056 | |
Opal L Smith, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 220 E. Harris, San Angelo, TX 76903 Phone: 325-658-1511 |