Individual
RYAN STANDAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN
Contact information
Practice address
3108 CLEARWATER DR, STE A, PRESCOTT, AZ 86305-7170
(480) 443-8400
Mailing address
4550 E BELL RD, SUITE 172, PHOENIX, AZ 85032-9306
(480) 443-8400
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP7623
AZ
363LG0600X
Gerontology Nurse Practitioner
AP7623
AZ
Other
Enumeration date
02/04/2015
Last updated
04/19/2016
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