Individual
FELICA DENISE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
Mailing address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904014
MS
Other
Enumeration date
07/09/2021
Last updated
01/26/2022
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