Individual provider · NPI-1

Judy Banner, APRN

Nurse Practitioner, Pediatrics · Oklahoma City, OK

NPI number1891043725
StatusActive
Last updated in NPPESAug 27, 2012

Details

NPI
1891043725
Entity type
Individual (NPI-1)
Name
Judy Banner
Credential
APRN
Sex
Female
Sole proprietor
No
Enumeration date
Aug 27, 2012
Last updated
Aug 27, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsR62457OKYes

Practice location

3330 Nw 56th St
Suite 400
Oklahoma City, OK 73112-4479

Phone 405-945-4220

Mailing address

1400 Redbud Holw
Edmond, OK 73034-9714

Phone 405-562-0213

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