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Individual

RYAN E WIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1301 S CRISMON RD, MESA, AZ 85209-3767
(480) 358-6100
Mailing address
129 W LAKE MEAD PKWY, #B-18, HENDERSON, NV 89015-7055
(702) 564-4440
(702) 558-1522

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA0742
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
587114
AZ
05
PENDING
NV
Enumeration date
08/28/2009
Last updated
12/05/2018
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