Henricksen, Mary K

Henricksen, Mary K is an individual health care provider with primary practice located at 580 W College Ave , Marquette MI 49855-2705. 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. Henricksen, Mary K can be contacted via phone (906) 225-3406.

Contact Information

Primary practice address
580 W College Ave Marquette MI 49855-2705
Phone: (906) 225-3406
Fax: (906) 225-3094
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704081708 Michigan

Profile Details

NPI number 1821070392
LBN Legal business name Henricksen, Mary K
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated Apr 22nd, 2008 - about 16 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 1821070392 NPPES
Michigan MEDICAID 104135850
Michigan Other 43288000
Michigan Other 430051912
Michigan Other MH081708

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