Damery, Mary M.

Damery, Mary M. is an individual health care provider with primary practice located at 611 W Park St , Urbana IL 61801-2529. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Damery, Mary M. can be contacted via phone (217) 383-3303.

Contact Information

Primary practice address
611 W Park St Urbana IL 61801-2529
Phone: (217) 383-3303
Fax: (217) 383-3265
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209005925 Illinois

Profile Details

NPI number 1528056504
LBN Legal business name Damery, Mary M.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Apr 12th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528056504 NPPES
Illinois Other 209-005925 IL APN LICENSE #
Illinois Other 041298740 IL APN LICENSE #
Illinois Other L031806 IL APN LICENSE #
Illinois Other 0841504038 IL APN LICENSE #

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