Provider Demographics
NPI:1114950284
Name:RYERSON, CHERYL A (CFA)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:A
Last Name:RYERSON
Suffix:
Gender:F
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3699
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:NM
Mailing Address - Zip Code:87015-3699
Mailing Address - Country:US
Mailing Address - Phone:505-832-8982
Mailing Address - Fax:505-832-8983
Practice Address - Street 1:3700 OSUNA RD NE STE 614
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4441
Practice Address - Country:US
Practice Address - Phone:505-341-0304
Practice Address - Fax:505-341-0304
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM00F751246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist