Individual
RYAN WATERBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
220537
WI
367500000X
Certified Registered Nurse Anesthetist
R172071
MN
Other
Enumeration date
03/11/2015
Last updated
03/11/2015
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