Individual
MARYANN HOLBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
81 SYLVANIA DR, BEAVERCREEK, OH 45440-3271
(937) 431-9531
Mailing address
4155 LISA DR STE A, TIPP CITY, OH 45371-8425
(937) 287-8178
(937) 669-4566
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
46500
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2071681
—
OH
Enumeration date
02/06/2007
Last updated
10/16/2020
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