LIA BANKA

WAKE FOREST, NC
NPI1699418822
Former NameLIA MICHELLE KENYON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: NC  5021022)
Additional Taxonomies163W00000X Registered Nurse
(Licence: NC  UQMI1VS2)
Enumeration Date2022-04-15
Last Update Date2024-11-22
Business Address
LIA BANKA FNP-C
605 W HOLDING AVE
WAKE FOREST, NC 27587-2848
Phone number: 802-578-7342
Mailing Address
LIA BANKA FNP-C
605 W HOLDING AVE
WAKE FOREST, NC 27587-2848
Phone number: 802-578-7342