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General NPI Number Information
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NPI Number | 1790767853
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Entity Type | Individual
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Provider Name | KATHRYN S BENDER CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 901 LAKESHORE DR
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City | ISHPEMING
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State | MI
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Zip | 49849-1367
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Country | US
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Telephone | 906-486-4431
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Fax |
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Provider Business Mailing Address
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Address Line | 811 W KAYE AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-2614
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Country | US
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Telephone | 906-226-8511
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704157469
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License Number State | MI
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