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Individual

CIERRA KRISTINE RYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1108 W INDIAN SCHOOL RD, SUITE B, PHOENIX, AZ 85013-3107
(602) 773-5600
Mailing address
154 MERCY WAY, POWDER SPRINGS, GA 30127-6854

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
363A00000X
Physician Assistant
Primary
10404
GA
363AM0700X
Medical Physician Assistant
6169
AZ

Other

Enumeration date
07/01/2012
Last updated
08/09/2021
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