Provider Demographics
NPI:1093761165
Name:CAIRNS, MARY MARGARET (CRNA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:CAIRNS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MARGARET
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:2133 BEDROCK RD NW
Mailing Address - Street 2:
Mailing Address - City:DELLROY
Mailing Address - State:OH
Mailing Address - Zip Code:44620-9608
Mailing Address - Country:US
Mailing Address - Phone:330-735-3289
Mailing Address - Fax:
Practice Address - Street 1:1460 ORANGE ST
Practice Address - Street 2:COSHOCTION COUNTY MEMORIAL HOSPITAL
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-2229
Practice Address - Country:US
Practice Address - Phone:740-622-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN106362367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0793315Medicaid
OH0793315Medicaid