Provider Demographics
NPI:1376832576
Name:STRASBURG, RYAN G (CRNA)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:G
Last Name:STRASBURG
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:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PARK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56470-0432
Mailing Address - Country:US
Mailing Address - Phone:218-732-9464
Mailing Address - Fax:218-732-0249
Practice Address - Street 1:506 HENRIETTA AVE N
Practice Address - Street 2:
Practice Address - City:PARK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56470
Practice Address - Country:US
Practice Address - Phone:218-732-9464
Practice Address - Fax:218-732-0249
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR30705367500000X
MN979367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND15892Medicaid
ND15892Medicaid