Individual
DIANE RYLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2624 OAK RIDGE DR, ROCKY FACE, GA 30740-9071
(423) 488-3283
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN091337
GA
163W00000X
Registered Nurse
RN127990
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10810
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3633933
—
TN
01
—
4100326
BLUE CROSS BLUE SHIELD TN
TN
05
—
935938084A
—
GA
01
—
N375502
WELLCARE (GA MEDICAID)
GA
01
—
P00213091
RAILROAD MEDICARE
TN
Enumeration date
02/12/2007
Last updated
02/27/2012
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