Individual
MARY ELIZABETH GORMAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 872-7388
(513) 872-7385
Mailing address
2368 VICTORY PKWY, SUITE 501, CINCINNATI, OH 45206-2859
(513) 872-7388
(513) 872-7385
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN211607
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0808997
—
OH
05
—
74413030
—
KY
Enumeration date
06/15/2006
Last updated
07/08/2007
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