Banknell, Misty Nicole

Banknell, Misty Nicole is an individual health care provider with primary practice located at 230 N Jefferson St Ne , Milledgeville GA 31061-3418. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Banknell, Misty Nicole can be contacted via phone (478) 453-8484.

Contact Information

Primary practice address
230 N Jefferson St Ne Milledgeville GA 31061-3418
Phone: (478) 453-8484
Fax: (478) 452-0987
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 005333 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 005333 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 005333 Georgia

Profile Details

NPI number 1609034453
LBN Legal business name Banknell, Misty Nicole
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2008
Last updated Mar 11th, 2015 - about 10 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 1609034453 NPPES
Other P00644516 RR MEDICARE PIN
Other 005333 RR MEDICARE PIN

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