Individual
LIANA GILL RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
114 W 11TH ST, SILVER CITY, NM 88061-5136
(575) 388-1511
(575) 388-3465
Mailing address
114 W 11TH ST, SILVER CITY, NM 88061-5136
(575) 388-1511
(575) 388-3465
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2006-0037
NM
363AM0700X
Medical Physician Assistant
Primary
PA2006 0037
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14582244
—
NM
Enumeration date
11/20/2006
Last updated
01/16/2009
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