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Individual

MRS. MARY KATHRYN GANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
345 NORTH COUNTY LINE HWY, DEERFIELD, MI 49238
(517) 447-4053
Mailing address
345 NORTH COUNTY LINE HWY, DEERFIELD, MI 49238
(517) 447-4053

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
47-04-198423
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4882886
MI
Enumeration date
10/03/2006
Last updated
07/09/2007
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