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Individual

SUSAN BANKSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
3109 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-4361
(228) 818-1111
Mailing address
2023 S HILL DR, BILOXI, MS 39532-4341
(228) 594-1711

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
9175676
FL
367500000X
Certified Registered Nurse Anesthetist
AP04993
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
R854110
MS

Other

Enumeration date
03/23/2006
Last updated
07/08/2007
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