Individual
ROBERT LAWRENCE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7580 CLARINGTON CV, SOUTHAVEN, MS 38671-5657
(662) 349-9136
(662) 349-0677
Mailing address
1856 PECAN DR, HERNANDO, MS 38632-8023
(662) 429-5909
(662) 349-0677
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
APN0000009584
TN
367500000X
Certified Registered Nurse Anesthetist
C00318 CRNA
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
R691259
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122694
—
MS
Enumeration date
09/02/2006
Last updated
07/08/2007
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