Individual
JENNIFER DYAN THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4766
Mailing address
27992 HAMBELTONIAN DR, CHESTERFIELD, MI 48047-4897
(586) 909-9541
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704221361
MI
Other
Enumeration date
10/05/2006
Last updated
10/17/2019
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