Individual
ERIKA ANN BANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
606 MARLOWS FORD RD APT 202, LOUISVILLE, KY 40245-4767
(502) 640-8404
Mailing address
606 MARLOWS FORD RD APT 202, LOUISVILLE, KY 40245-4767
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TC289
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/08/2022
Last updated
08/11/2023
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