Individual
AMY BANNERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHLEBOTOMIST
Contact information
Practice address
133 GLENDALE VILLAGE LN, WALLACE, NC 28466-1637
(910) 787-6633
Mailing address
133 GLENDALE VILLAGE LN, WALLACE, NC 28466-1637
(910) 787-6633
Taxonomy
Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
Primary
Y2G5T7L7
NC
Other
Enumeration date
03/02/2026
Last updated
03/02/2026
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