Individual
KATHRYN S BENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 LAKESHORE DR, ISHPEMING, MI 49849-1367
(906) 486-4431
Mailing address
811 W KAYE AVE, MARQUETTE, MI 49855-2614
(906) 226-8511
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704157469
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104654138
—
MI
01
—
44337700
WISC MEDICAID PIN
WI
01
—
KB157469
BLUESHIELD PIN
MI
Enumeration date
11/15/2005
Last updated
07/09/2013
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