Individual
AMY BANNISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7880 WREN AVE STE C133, GILROY, CA 95020-7801
(408) 842-0278
Mailing address
7880 WREN AVE STE C133, GILROY, CA 95020-7801
(408) 842-0278
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
930
CA
363LF0000X
Family Nurse Practitioner
95010813
CA
Other
Enumeration date
01/15/2021
Last updated
02/09/2021
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