Individual
BECKA I BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4537 S NUCOR RD, CRAWFORDSVILLE, IN 47933-7969
(765) 362-3579
Mailing address
4537 S NUCOR RD, CRAWFORDSVILLE, IN 47933-7969
(765) 362-3579
(877) 558-9529
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002274A
IN
Other
Enumeration date
08/14/2017
Last updated
06/29/2021
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