CASEY BANAHAN BAINE

JACKSON, MS
NPI1245835263
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: MS  904142)
Enumeration Date2020-11-30
Last Update Date2023-11-28
Business Address
CASEY BANAHAN BAINE ACAGNP
969 LAKELAND DR
JACKSON, MS 39216-4606
Phone number: 601-200-3631
Mailing Address
CASEY BANAHAN BAINE ACAGNP
5959 S SHERWOOD FOREST BLVD
BATON ROUGE, LA 70816-6038
Phone number: 601-200-3631