Provider Demographics
NPI:1942211834
Name:BABETT, MARYANN H (CRNA)
Entity Type:Individual
Prefix:MS
First Name:MARYANN
Middle Name:H
Last Name:BABETT
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 1:1890 LAKE MIONA DR
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-6406
Mailing Address - Country:US
Mailing Address - Phone:352-205-8187
Mailing Address - Fax:
Practice Address - Street 1:3133 SW 32ND AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4446
Practice Address - Country:US
Practice Address - Phone:352-237-8400
Practice Address - Fax:352-237-7190
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9172715367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG2949OtherBCBSFL PROVIDER NUMBER
FLE6084Medicare ID - Type UnspecifiedPROVIDER NUMBER