MAGGIE FORD BANE

SOUTH BOSTON, VA
NPI1972861169
Former NameMAGGIE FORD WILKINS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: VA  0024170022)
Additional Taxonomies363LA2200X Nurse Practitioner, Adult Health
(Licence: NC  5005825)
Enumeration Date2012-04-25
Last Update Date2020-09-15
Business Address
Mrs. MAGGIE FORD BANE NP-C
2206 WILBORN AVE
SOUTH BOSTON, VA 24592-1630
Phone number: 434-517-8627
Mailing Address
Mrs. MAGGIE FORD BANE NP-C
2206 WILBORN AVE
SOUTH BOSTON, VA 24592-1630
Phone number: 434-517-8627