Individual
MRS. ANTOINETTE SHANE WILSON BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
8740 MARY FRANCES DR, SOUTHAVEN, MS 38671-2508
(901) 406-4401
(901) 791-4390
Mailing address
8740 MARY FRANCES DR, SOUTHAVEN, MS 38671-2508
(901) 406-4401
(901) 791-4390
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
930665
MS
Other
Enumeration date
11/10/2025
Last updated
11/14/2025
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