Individual
RYAN FREESTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 W MAPLE ST, FARMINGTON, NM 87401-5630
(505) 609-2000
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-75957
NM
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA-01433
NM
Other
Enumeration date
06/16/2016
Last updated
10/10/2016
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