Individual
MRS. RENA M. BANNISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2325 PANSY ST SW, SUITE E, HUNTSVILLE, AL 35801-3834
(256) 533-4626
(253) 533-4710
Mailing address
111 GRAY RUN DR SW, HUNTSVILLE, AL 35824-1349
(256) 533-4626
(256) 533-4710
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AL 1 021431
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000079656
—
AL
Enumeration date
07/03/2006
Last updated
07/08/2007
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