Provider Demographics
NPI:1104928993
Name:ZADOROZNY, LEDANA RUTH (CRNA/MS ARNP EDD)
Entity type:Individual
Prefix:MS
First Name:LEDANA
Middle Name:RUTH
Last Name:ZADOROZNY
Suffix:
Gender:F
Credentials:CRNA/MS ARNP EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 MEDICINE BOW TRL
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-2033
Mailing Address - Country:US
Mailing Address - Phone:830-965-5169
Mailing Address - Fax:
Practice Address - Street 1:801 BEDELL
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-4112
Practice Address - Country:US
Practice Address - Phone:830-775-8566
Practice Address - Fax:830-775-6632
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX590441367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85589UOtherBCBSTX
TX088633506Medicaid
TX85589UOtherBCBSTX