Individual
MS. COURTNEY B BANCOOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
224 HIGHLAND DR, LINDALE, TX 75771-2627
(903) 570-5999
Mailing address
755 S BECKHAM AVE, TYLER, TX 75701-1903
(903) 534-4684
(903) 534-4726
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
169545
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
169545
LVN
TX
Enumeration date
02/16/2018
Last updated
02/16/2018
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