Individual
MARY BETH BOESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
2006 HOGBACK RD STE 5A, ANN ARBOR, MI 48105-9750
(734) 263-2395
(734) 773-3471
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704201092
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265408272
—
MI
01
—
430F364420
BCBSM
MI
Enumeration date
02/28/2006
Last updated
12/05/2024
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