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NPI Code Detail

MEDICARE: SUSAN BANKSTON CRNA

MEDICARE: SUSAN BANKSTON CRNA
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
1367500000XCertified Registered Nurse Anesthetist9175676FL
2367500000XCertified Registered Nurse AnesthetistR854110MS
3367500000XCertified Registered Nurse AnesthetistAP04993LA

General Provider Information

NPI Number : 1982663209
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN BANKSTON CRNA
Provider Business Mailing Address
First Line : 2023 S HILL DR
Second Line :
City : BILOXI
State : MS
Zip : 39532-4341
Country : US
Telephone Number : 228-594-1711
Fax Number :
Provider Business Practice Location Address
First Line : 3109 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-4361
Country : US
Telephone Number : 228-818-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 07/08/2007

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Directions to “ SUSAN BANKSTON CRNA” Practice Location

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