Individual
JACEE MAE BANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2010 CHESTNUT ST STE B, VAN BUREN, AR 72956-5340
(479) 262-2724
(479) 262-2727
Mailing address
3200 S 55TH ST, FORT SMITH, AR 72903-4714
(479) 461-2145
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
230639
AR
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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