Individual
EARLENE F BANVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
ONE PARKLAND DRIVE, DERRY, NH 03038
(603) 421-2163
(978) 946-8206
Mailing address
PO BOX 1849, LEWISTON, ME 04241-1849
(207) 784-2554
(207) 777-5363
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
052873-23-11
NH
367500000X
Certified Registered Nurse Anesthetist
123030
MA
Other
Enumeration date
05/19/2006
Last updated
12/03/2008
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