Healthcare Provider Details

I. General information

NPI: 1245239110
Provider Name (Legal Business Name): THOMASENE BYERS C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4009 WOOD HAVEN CT
LAMBERTVILLE MI
48144-9323
US

IV. Provider business mailing address

4009 WOOD HAVEN CT
LAMBERTVILLE MI
48144-9323
US

V. Phone/Fax

Practice location:
  • Phone: 734-856-2448
  • Fax: 734-856-2448
Mailing address:
  • Phone: 734-856-2448
  • Fax: 734-856-2448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN129688
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: