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1326824020
KEVIN BANKSON
MARRERO, LA
NPI
1326824020
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: LA 207227)
Enumeration Date
2023-09-07
Last Update Date
2023-09-22
Business Address
KEVIN BANKSON
1111 MEDICAL CENTER BLVD STE S850
MARRERO, LA 70072-3173
Phone number: 504-349-6450
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Mailing Address
KEVIN BANKSON
125 W 40TH PL
CUT OFF, LA 70345-3078
Phone number:
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