Individual
MARY BANNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(610) 834-1122
Mailing address
712 CHURCH LN, YEADON, PA 19050-3503
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
9500868
PA
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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