Provider Demographics
NPI:1154765279
Name:WERBLOW, RYAN (MSN, RN, CRNA)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:WERBLOW
Suffix:
Gender:M
Credentials:MSN, RN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5715 ELLSWORTH AVE
Mailing Address - Street 2:APT B4
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1748
Mailing Address - Country:US
Mailing Address - Phone:989-255-4846
Mailing Address - Fax:
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:989-255-4846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC201467163W00000X
PARN622873163W00000X
WARN60176013163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse