Healthcare Provider Details

I. General information

NPI: 1366279614
Provider Name (Legal Business Name): RYAN DELANEY CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1446 HARPER ST
AUGUSTA GA
30912-0012
US

IV. Provider business mailing address

229 HIGH POINT WAY
EVANS GA
30809-6411
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-5437
  • Fax:
Mailing address:
  • Phone: 706-421-8407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN-CRNA151210
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: