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General NPI Number Information
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NPI Number | 1639794324
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Entity Type | Individual
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Provider Name | RYAN ABRAHAM CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 6200 N LA CHOLLA BLVD
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City | TUCSON
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State | AZ
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Zip | 85741-3529
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Country | US
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Telephone | 520-742-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 17989 RESTORATION CIR
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City | GULFPORT
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State | MS
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Zip | 39503-5237
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Country | US
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Telephone | 321-749-9317
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 336781
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 901636
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN9309082
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License Number State | FL
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