Ryan, Jacob D

Ryan, Jacob D is an individual health care provider with primary practice located at 424 W Mcneese St , Lake Charles LA 70605-5547. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Ryan, Jacob D can be contacted via phone (337) 478-0511.

Contact Information

Primary practice address
424 W Mcneese St Lake Charles LA 70605-5547
Phone: (337) 478-0511
Fax: (337) 478-5660
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN075556 Louisiana

Profile Details

NPI number 1538211206
LBN Legal business name Ryan, Jacob D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated Oct 12th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538211206 NPPES
Louisiana Other 391870ZMJF MEDICARE PTAN
Louisiana MEDICAID 1438057 MEDICARE PTAN

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