Healthcare Provider Details

I. General information

NPI: 1275682080
Provider Name (Legal Business Name): CHERYL A. RYERSON, CFA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 OSUNA RD NE SUITE 614
ALBUQUERQUE NM
87109-4492
US

IV. Provider business mailing address

PO BOX 3699
EDGEWOOD NM
87015-3699
US

V. Phone/Fax

Practice location:
  • Phone: 505-341-0070
  • Fax: 505-341-0304
Mailing address:
  • Phone: 505-832-8982
  • Fax: 505-832-8983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number00F751
License Number StateNM

VIII. Authorized Official

Name: CHERYL A RYERSON
Title or Position: ADMINISTRATOR
Credential: CFA
Phone: 505-832-8982