Individual
RYAN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5330 S HIGHWAY 95, FORT MOHAVE, AZ 86426-9225
(928) 788-2273
Mailing address
2351 E AMBER AVE, FORT MOHAVE, AZ 86426-7304
(801) 520-1543
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6220295-3102
UT
Other
Enumeration date
08/05/2015
Last updated
09/08/2025
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