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General NPI Number Information
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NPI Number | 1447324454
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Entity Type | Individual
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Provider Name | LIANA GILL RYAN PA C
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 114 W 11TH ST
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City | SILVER CITY
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State | NM
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Zip | 88061-5136
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Country | US
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Telephone | 575-388-1511
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Fax | 575-388-3465
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Provider Business Mailing Address
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Address Line | 114 W 11TH ST
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City | SILVER CITY
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State | NM
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Zip | 88061-5136
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Country | US
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Telephone | 575-388-1511
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Fax | 575-388-3465
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA2006 0037
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2006-0037
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License Number State | NM
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