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ELIZABETH RYAN PA
>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1376015487
Individual Registrant: ELIZABETH RYAN PA
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
522 PRONGHORN PLACE MORAN, WY 83013-8301 US
Tel: 307-543-2514 Fax: --
Tel: 307-543-2514 Fax: --
Contact information for business:
PO BOX 428 JACKSON, WY 83001-0428 US
Tel: 307-543-2514 Fax: --
Tel: 307-543-2514 Fax: --
Registration Information:
NPI: 1376015487
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | WY | PT926 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 204777200 | WY | 05 |
