MEDICARE: RYAN STERLING NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	54500	NM
2	363LF0000X	Family Nurse Practitioner	AP139184	TX

General Provider Information

NPI Number	:	1912476102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN STERLING NP

Provider Business Mailing Address
First Line	:	6962 CANYON RIDGE WAY
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4344
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6962 CANYON RIDGE WAY
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4344
Country	:	US
Telephone Number	:	915-474-5755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2018
Last Update Date	:	11/16/2018

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