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-- CLINTON DALE BANNING -- FNP

Individual Provider (NPI-1) Active

Nurse Practitioner, Family

Provider Information

NPI Number
1629307533
Provider Type
Individual Provider (NPI-1)
Credentials
FNP
Status
Active

Contact & Location

Address
500 SW RAMSEY, GRANTS PASS, OR, 97527
Phone
(541) 472-7069

Specialties & Taxonomies

Registered Nurse License: OR #2001141562RN
Nurse Practitioner, Family Primary License: OR #201050003NP

All Addresses

MAILING

PO BOX 338 133 WINNIE WALKER LANE

GLENDALE, OR, 974420338

(541) 832-2335

LOCATION

500 SW RAMSEY

GRANTS PASS, OR, 97527

(541) 472-7069