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Individual
RYAN R GUNN
Active
Individual
RYAN R GUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
706355
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202183402
—
TX
01
—
75-2616977-042
TRICARE
TX
01
—
892N40
BCBS
TX
01
—
P01200575
RAIL ROAD
TX
Enumeration date
04/29/2008
Last updated
04/01/2016
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