Individual
JANE P MAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
18101 OAKWOOD BLVD, ANESTHESIA DEPT, DEARBORN, MI 48124-4089
(313) 593-7820
(313) 593-8894
Mailing address
18101 OAKWOOD BLVD, ANESTHESIA DEPT, DEARBORN, MI 48124-4089
(313) 593-7820
(313) 593-8894
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704104648
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4311653
—
MI
Enumeration date
08/24/2006
Last updated
07/08/2007
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