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Individual

MRS. EMERITA TABOR BANAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.R.N.A.

Contact information

Practice address
11800 EAST 12-MILE RD, WARREN, MI 48093
(586) 573-5260
Mailing address
3974 NOWAK DR, STERLING HEIGHTS, MI 48310-5325
(586) 242-5424

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704086757
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1597477
MI
Enumeration date
12/29/2006
Last updated
07/08/2007
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