Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RYAN OTTO
ActiveRYAN OTTO is a Medical Physician Assistant healthcare provider located in KENOSHA, Wisconsin. NPI 1457004517 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · KENOSHA, WI
Registration Details
- NPI Number
- 1457004517
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 30, 2022 (4.5037205617751 yrs)
- Last Updated
- Aug 17, 2022
- License
-
IL (IL)
Practice Information
- Address
-
1400 43RD STKENOSHA, WI, 531402741Browse WI providers · Browse ZIP 53140
- Phone
- 4146512814
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Other Medical Physician Assistant Providers in KENOSHA, WI
| Name | Credential | NPI |
|---|---|---|
| ANDREA M MATTISON | PAC | 1902852072 |
| HEATHER M BARRETT | PA | 1629080247 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.