Misty Nicole Banknell PA-C

NPI 1609034453 - Physician Assistant - 363AM0700X

NPI Details
NPI 1609034453
Gender Female
Enumeration Date 05/29/2008
Last Updated 03/11/2015
Entity Type Individual
Active Over 8 years ago
Practice Location
230 N JEFFERSON ST NE
MILLEDGEVILLE GA, 31061-3418, US
Phone (478) 453-8484
Fax (478) 452-0987
Business Location
2400 BELLEVUE RD STE 21A
DUBLIN GA, 31021-2890, US
Phone (478) 275-7202
Fax (478) 274-8418
Toxanomy
Taxonomy Code 363AM0700X
License State Georgia
License Number 005333
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According to our database, Misty Nicole Banknell PA-C NPI is 1609034453, taxonomy code is 363AM0700X and license number is 005333, license state is located at Georgia. Misty Nicole Banknell PA-C physically located at 230 N Jefferson St Ne, Milledgeville GA, 31061-3418. NPI Number Misty Nicole Banknell PA-C has the Individual type.

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1609034453 NPI number is provided on an as is basis without warranty of any kind. 1609034453 is maintained by the National Plan & Provider Enumeration System. The contents of Misty Nicole Banknell PA-C are for informational purposes only.