Individual
MS. LINDSAY M. BANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
(417) 820-8852
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-6863
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2014012653
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891119251
—
MO
05
—
211239001
—
AR
Enumeration date
02/05/2014
Last updated
06/22/2020
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