Individual
MS. RYANELLE TRESE FUQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
19 FREEMAN ST, BUFFALO, NY 14215-2704
(716) 308-2645
(716) 608-1328
Mailing address
19 FREEMAN ST, BUFFALO, NY 14215-2704
(716) 308-2645
(716) 608-1328
Taxonomy
Speciality
Code
Description
License number
State
163WE0900X
Enterostomal Therapy Registered Nurse
Primary
881719
NY
164W00000X
Licensed Practical Nurse
291556
NY
Other
Enumeration date
10/22/2009
Last updated
11/07/2024
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