MEDICARE: SHERYL MEI BANKSTON FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	17931	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SC10686084	OTHER	SC	MEDICARE PIN
2	SC10686121	OTHER	SC	MEDICARE PIN
4	SC10685019	OTHER	SC	MEDICARE PIN
5	SC1068J577	OTHER	SC	MEDICARE PIN
6	P01226933	OTHER	SC	RAILROAD MEDICARE
7	SC10686067	OTHER	SC	MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972859130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERYL MEI BANKSTON FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 743070
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-3070
Country	:	US
Telephone Number	:	864-560-4304
Fax Number	:	864-560-4413

Provider Business Practice Location Address
First Line	:	1200 E MAIN ST
Second Line	:	SUITE 12
City	:	SPARTANBURG
State	:	SC
Zip	:	29307-1711
Country	:	US
Telephone Number	:	864-560-9260
Fax Number	:	864-560-9265

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2012
Last Update Date	:	11/19/2020

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Directions to “ SHERYL MEI BANKSTON FNP-BC” Practice Location

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