Individual
TOMMY LAWAYNE RIALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 232-3241
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 232-3241
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R53341
ND
367500000X
Certified Registered Nurse Anesthetist
R876982
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02089876
—
MS
Enumeration date
03/04/2015
Last updated
04/16/2024
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