Individual
DIANA BANNISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
6301 GASTON AVE STE 100W, DALLAS, TX 75214-6273
(214) 827-3610
(214) 821-4017
Mailing address
6301 GASTON AVE STE 100W, DALLAS, TX 75214-6273
(214) 827-3610
(214) 821-4017
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
670576
TX
Other
Enumeration date
01/18/2012
Last updated
11/19/2018
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