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Individual

MRS. KELLI LYNN BANKES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4863 DIAMOND TRACE TRL, FORT WORTH, TX 76244-7976
(817) 614-1292
Mailing address
4863 DIAMOND TRACE TRL, FORT WORTH, TX 76244-7976
(817) 614-1292

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary

Other

Enumeration date
04/09/2012
Last updated
04/09/2012
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