Individual
STACEY GLEN BANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1000
Mailing address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23374
SC
Other
Enumeration date
11/06/2019
Last updated
12/09/2025
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