Individual
KIMBERLY SUE BANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3440 S TINKEY RD, MENTONE, IN 46539-9288
(574) 253-5809
Mailing address
3440 S TINKEY RD, MENTONE, IN 46539-9288
(574) 253-5809
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28173352A
IN
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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