| NPI | 1942864426 |
|---|---|
| Former Name | KRYSTAL K BANEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK R0069713) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60513914) |
| 363LF0000X Nurse Practitioner, Family (Licence: ID 56934) | |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2025-01-09 |