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1669000105
MICHELE L. BANNISTER
ORANGE PARK, FL
NPI
1669000105
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: FL 11015678)
Enumeration Date
2020-03-30
Last Update Date
2021-11-10
Business Address
MICHELE L. BANNISTER APRN, FNP-BC
930 KINGSLEY AVE
ORANGE PARK, FL 32073-4704
Phone number: 904-269-0500
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Mailing Address
MICHELE L. BANNISTER APRN, FNP-BC
930 KINGSLEY AVE
ORANGE PARK, FL 32073-4704
Phone number: 904-269-0500
Copy
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