Individual
MS. MARIE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
101 S CANAL ST, CARLSBAD, NM 88220-5713
(575) 628-1614
(575) 234-0591
Mailing address
PO BOX 1574, ROSWELL, NM 88202-1574
(575) 628-1614
(575) 234-0591
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP00172
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Q5228
—
NM
01
—
00NM01R94X
BCBS
NM
01
—
P00946801
RR MEDICARE
NM
05
—
Q5228
—
NM
Enumeration date
04/27/2006
Last updated
12/27/2011
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