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NPI Code Detail

MEDICARE: LAURA JEAN RYAN CRNP

MEDICARE: LAURA JEAN RYAN CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerR109434MD

General Provider Information

NPI Number : 1700923976
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA JEAN RYAN CRNP
Provider Business Mailing Address
First Line : 836 PINE DR
Second Line :
City : RIDGWAY
State : CO
Zip : 81432-9494
Country : US
Telephone Number : 301-236-4322
Fax Number :
Provider Business Practice Location Address
First Line : 500 WEST PACIFIC AVENUE
Second Line :
City : TELLURIDE
State : CO
Zip : 81435-1229
Country : US
Telephone Number : 970-424-1673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 03/07/2023

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Directions to “ LAURA JEAN RYAN CRNP” Practice Location

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