Individual
SHAVON KYPHER BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1635 POPPS FERRY RD, BILOXI, MS 39532-2312
(228) 860-5551
Mailing address
248 DEBUYS RD APT 97, BILOXI, MS 39531-3509
(228) 860-5551
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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