Bannister, Jacqueline

Bannister, Jacqueline is an individual health care provider with primary practice located at 6360 Techster Blvd Ste 1 , Fort Myers FL 33966-4805. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Bannister, Jacqueline can be contacted via phone (239) 223-2751.

Contact Information

Primary practice address
6360 Techster Blvd Ste 1 Fort Myers FL 33966-4805
Phone: (239) 223-2751
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X ARNP9204616 Florida

Profile Details

NPI number 1194089227
LBN Legal business name Bannister, Jacqueline
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2012
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194089227 NPPES
Florida MEDICAID 007338100

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