Koterba, Mary E

Koterba, Mary E is an individual health care provider with primary practice located at 3301 Broadway St , Quincy IL 62301-3713. 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. Koterba, Mary E can be contacted via phone (217) 222-6550.

Contact Information

Primary practice address
3301 Broadway St Quincy IL 62301-3713
Phone: (217) 222-6550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 118799 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704351565 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209006248 Illinois

Profile Details

NPI number 1699754820
LBN Legal business name Koterba, Mary E
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2006
Last updated Feb 16th, 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 1699754820 NPPES
Michigan Other 4704351565 MI LICENSE
Michigan MEDICAID 915820112 MI LICENSE

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