Individual
MRS. MALLORY BANKSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
12880 PLANK RD, BAKER, LA 70714-4909
(225) 774-7111
(225) 774-7714
Mailing address
12880 PLANK RD, BAKER, LA 70714-4909
(225) 774-7111
(225) 774-7714
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07816
LA
Other
Enumeration date
06/27/2014
Last updated
08/12/2022
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