Provider Demographics
NPI:1538154224
Name:RITTER, RYAN G (CRNA)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:G
Last Name:RITTER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1016
Mailing Address - Country:US
Mailing Address - Phone:605-322-2754
Mailing Address - Fax:605-322-2727
Practice Address - Street 1:800 E 21ST ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1016
Practice Address - Country:US
Practice Address - Phone:605-322-2754
Practice Address - Fax:605-322-2727
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR028099367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0040833OtherBLUE CROSS OF SD
SD0042073OtherWELLMARK
IA0574624Medicaid
IA1574624Medicaid
SD5753693Medicaid
SD9218947OtherDAKOTACARE
MN051K2RIOtherMN BLUE CROSS BS
SD5753690Medicaid
SDS42073Medicare PIN
SD9218947OtherDAKOTACARE
IA0574624Medicaid
SDS40833Medicare PIN