Healthcare Provider Details

I. General information

NPI: 1326007485
Provider Name (Legal Business Name): RYAN RAY MORGAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2006
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1257 N BUCKNER ST
DERBY KS
67037-2721
US

IV. Provider business mailing address

1257 N BUCKNER ST
DERBY KS
67037-2721
US

V. Phone/Fax

Practice location:
  • Phone: 316-788-5939
  • Fax: 316-788-5945
Mailing address:
  • Phone: 316-788-5939
  • Fax: 316-788-5945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number55475
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: