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Individual

BRENDA T BANKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
2647 OLIVET CEMETERY RD, MULLINS, SC 29574-7506
(843) 430-8602
Mailing address
2647 OLIVET CEMETERY RD, MULLINS, SC 29574-7506
(843) 430-8602

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
18124
SC

Other

Enumeration date
08/23/2018
Last updated
08/23/2018
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