Individual
MRS. DEBERA W MOENNICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
860 E BROAD ST, SUITE I, ELYRIA, OH 44035-6542
(440) 323-8515
(440) 323-7900
Mailing address
139 WESTCHESTER DR, AMHERST, OH 44001-3428
(440) 988-8918
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
122349
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2144709
—
OH
Enumeration date
08/16/2006
Last updated
01/09/2008
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