Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 69603 | MN |
N | 208200000X | Surgeon | 94-08447 | KS |
N | 208600000X | Surgeon | 94-08447 | KS |
NPI | 1013322759 |
---|---|
Provider Name | Miss Randi J Ryan |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2014 |
Last Update Date | 19/08/2021 |