| 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 | 24 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 | 465 |
| Entity Name | Shannon Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770587149 PECOS PAC ID: 0840103727 Enrollment ID: O20031222000702 |
| Entity Name | Obhg Texas Holdings Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083917769 PECOS PAC ID: 3577713072 Enrollment ID: O20121018000279 |
| 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 |
Mary-jo Urbano, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 120 E Harris Ave, San Angelo, TX 76903 Phone: 325-747-6741 | |
Kelsey Danielle Walts, Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 3501 Knickerbocker Rd, San Angelo, TX 76904 Phone: 325-747-2285 Fax: 325-747-4635 | |
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 |