Individual
MARYANN THERESA HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
51 NORTH 39TH STREET, PHILADELPHIA, PA 19104
(215) 662-8244
Mailing address
51 NORTH 39TH STREET, PHILADELPHIA, PA 19104
(215) 662-8244
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
RN 506734L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN506734L
PA
Other
Enumeration date
12/09/2008
Last updated
08/22/2012
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