Individual
RYAN A HULZEBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7150 CLEARVISTA DR, INDIANAPOLIS, IN 46256-1695
(317) 621-9002
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28220828A
IN
367500000X
Certified Registered Nurse Anesthetist
4770A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201284120
—
IN
05
—
74011602
—
KY
01
—
P01512412
RR MEDICARE
IN
Enumeration date
08/30/2006
Last updated
11/27/2023
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