Individual
MR. RYAN ROBERT DIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
135 S GIBSON ST, MEDFORD, WI 54451-1622
(715) 748-8100
(715) 748-8199
Mailing address
W6150 SUGAR BUSH LN, MEDFORD, WI 54451-8200
(715) 748-3370
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
327606
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
3726-33
WI
Other
Enumeration date
01/19/2009
Last updated
09/14/2010
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