Individual
KELLI BANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
61 LOGAN STREET, MARION, NC 28752-2856
(828) 559-1044
(828) 559-2039
Mailing address
61 LOGAN STREET, MARION, NC 28752-2856
(828) 559-1044
(828) 559-2039
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
804923
NC
363LF0000X
Family Nurse Practitioner
Primary
5009995
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831789817
GROUP NPI
—
Enumeration date
07/16/2015
Last updated
04/16/2024
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