Provider Demographics
NPI:1437588035
Name:HANLEY, MARIA V (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:V
Last Name:HANLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-2542
Mailing Address - Country:US
Mailing Address - Phone:248-703-1625
Mailing Address - Fax:
Practice Address - Street 1:246 HAMILTON RD
Practice Address - Street 2:PLEASE SELECT
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-2542
Practice Address - Country:US
Practice Address - Phone:248-703-1625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704259395367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered