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General NPI Number Information
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NPI Number | 1912409053
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Entity Type | Individual
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Provider Name | MARCIE BANKSTON MCPHILLIPS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/05/2018
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 1 PERIMETER PARK S STE 195A
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City | BIRMINGHAM
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State | AL
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Zip | 35243-2327
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Country | US
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Telephone | 866-849-0692
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Fax | 888-973-8821
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Provider Business Mailing Address
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Address Line | PO BOX 211699
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City | EAGAN
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State | MN
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Zip | 55121-3699
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Country | US
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Telephone | 866-849-0692
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Fax | 888-973-8821
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-136202
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11036461
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License Number State | FL
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