Individual
RYAN C GOLOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 666-2000
Mailing address
2204 IRONWOOD PL STE B, COEUR D ALENE, ID 83814-2662
(208) 765-8585
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
160305
CO
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-866A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160305
COLORADO LICENSE
CO
01
—
RNA-866A
IDAHO LICENSE
ID
Enumeration date
12/03/2007
Last updated
11/06/2017
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