Healthcare Provider Details

I. General information

NPI: 1467739912
Provider Name (Legal Business Name): MEGAN ANNE RYAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2011
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
BIDDEFORD ME
04005-9422
US

IV. Provider business mailing address

3376 LAUREL DR
GULF BREEZE FL
32563-3328
US

V. Phone/Fax

Practice location:
  • Phone: 207-283-7042
  • Fax:
Mailing address:
  • Phone: 518-368-2694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRNA213074
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number817218
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3-003161
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number817218
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9269992
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number532871-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: