Individual
RYAN MICHAEL GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(952) 924-5185
Mailing address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(952) 924-5185
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R175762-4
MN
367500000X
Certified Registered Nurse Anesthetist
R31002
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457655805
—
MN
Enumeration date
12/28/2010
Last updated
12/13/2013
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