Kathy Khristina Bannon, NP
Nurse Practitioner, Family in Terre Haute, IN. Individual provider (NPI-1).
NPI number1639832025
StatusActive
Last updated in NPPESOct 21, 2021
Details
- NPI
- 1639832025
- Entity type
- Individual (NPI-1)
- Name
- Kathy Khristina Bannon
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 21, 2021
- Certification date
- Oct 21, 2021
- Last updated
- Oct 21, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 28112203A | IN | Yes |
Practice location
2723 S 7th St Ste OTerre Haute, IN 47802-3562
Phone 812-232-1418 · Fax 812-232-2642
Mailing address
2723 S 7th St Ste OTerre Haute, IN 47802-3562
Phone 812-232-1418 · Fax 812-232-2642
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