Provider Demographics
NPI:1538998323
Name:RYALS, ANNE (CNM)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:RYALS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29018 HIGHWAY 160
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-7951
Mailing Address - Country:US
Mailing Address - Phone:210-383-8146
Mailing Address - Fax:
Practice Address - Street 1:US HIGHWAY 191 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:CHINLE
Practice Address - State:AZ
Practice Address - Zip Code:86503
Practice Address - Country:US
Practice Address - Phone:928-674-7197
Practice Address - Fax:928-674-7707
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0999701-CNM367A00000X
CORXN.0108771-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife