Provider Demographics
NPI:1407273972
Name:RAYBA, HANNAH MARIE
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:MARIE
Last Name:RAYBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46595 DUNNELLON DR E
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-3697
Mailing Address - Country:US
Mailing Address - Phone:586-277-9457
Mailing Address - Fax:586-690-8356
Practice Address - Street 1:46595 DUNNELLON DR E
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-3697
Practice Address - Country:US
Practice Address - Phone:586-277-9457
Practice Address - Fax:586-690-8356
Is Sole Proprietor?:No
Enumeration Date:2014-03-23
Last Update Date:2014-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703109494164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse