Individual
JENNIFER BANDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
4108 LB PROPST DR, CONOVER, NC 28613-8830
(828) 302-3431
Mailing address
4108 LB PROPST DR, CONOVER, NC 28613-8830
(828) 302-3431
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00584530
—
NC
Enumeration date
09/02/2020
Last updated
09/15/2020
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