Individual
KERRY A FAY-BANNISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
789 CENTRAL AVENUE, WENTWORTH DOUGLAS HOSPITAL, DOVER, NH 03820
(603) 749-7246
(603) 749-2453
Mailing address
3998 FAIR RIDGE DR, SUITE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
042782
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30011345
—
NH
Enumeration date
12/28/2005
Last updated
03/20/2015
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