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Individual

JENNIFER W BANKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
411 E VAUGHN AVE, SUITE 202, RUSTON, LA 71270-5972
(318) 251-3774
(318) 251-0442
Mailing address
411 E VAUGHN AVE, SUITE 202, RUSTON, LA 71270-5972
(318) 521-3774
(318) 251-0442

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APO3690
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1436283
LA
Enumeration date
03/09/2007
Last updated
11/30/2016
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