| Mary K Henricksen, CRNA | |
|
580 W College Ave, Marquette, MI 49855-2705 | |
| (906) 225-3406 | |
| (906) 225-3094 |
| Full Name | Mary K Henricksen |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 580 W College Ave, Marquette, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821070392 | NPI | - | NPPES |
| 104135850 | Medicaid | MI | |
| 43288000 | Other | WI | WI MEDICAID PIN |
| 430051912 | Other | MI | 430051912 |
| MH081708 | Other | MI | BLUESHIELD PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 4704081708 (Michigan) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mary K Henricksen, CRNA E3110 E Deer Lake Rd, Au Train, MI 49806-9512 Ph: (906) 892-8530 | Mary K Henricksen, CRNA 580 W College Ave, Marquette, MI 49855-2705 Ph: (906) 225-3406 |
Peter Skellenger, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 714 Spruce St, Apt #e, Marquette, MI 49855 Phone: 906-399-3611 | |
Sandra L Wachter, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 580 W College Ave, Marquette, MI 49855 Phone: 906-225-3406 Fax: 906-225-3094 | |
Janet M Simula, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 580 W College Ave, Marquette, MI 49855 Phone: 906-225-3406 Fax: 906-225-3094 | |
Kenneth L Mcneely, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 580 W College Ave, Marquette, MI 49855 Phone: 906-225-3406 Fax: 906-225-3094 | |
Lisa A Kuopus, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 580 W College Ave, Marquette, MI 49855 Phone: 906-225-3406 Fax: 906-225-3094 | |
Joseph Morris Holcomb, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 580 W College Ave, Marquette, MI 49855 Phone: 906-225-3595 | |
Laura V Brouillette, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 580 W College Ave, Marquette, MI 49855 Phone: 906-228-9440 |