NPI 1609034453

Misty Nicole Banknell, PAC

Practitioner Physician Assistant Milledgeville, GA

Practice location

Address: 230 N Jefferson St NE, Milledgeville, GA 31061-3418
Phone: (478) 453-8484
Fax: (478) 452-0987
Mailing address: 2400 Bellevue Rd STE 21a, Dublin, GA 31021-2890

Registered specialties (3)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 005333 (GA)

Other Physician Assistant providers in Georgia →

Medical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 005333 (GA)

Surgical Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence 005333 (GA)

Registry record

NPI: 1609034453
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 May 2008
Record last updated: 11 Mar 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.