Individual
KRISTEN NICOLE BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
21234 MARION RD, FREDONIA, KY 42411-9250
(270) 545-2929
Mailing address
21234 MARION RD, FREDONIA, KY 42411-9250
(270) 545-2929
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4011046
KY
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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