Clinton Dale Banning, FNP | |
500 Sw Ramsey, Grants Pass, OR 97527 | |
(541) 472-7069 | |
Not Available |
Full Name | Clinton Dale Banning |
---|---|
Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 500 Sw Ramsey, Grants Pass, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629307533 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 2001141562RN (Oregon) | Secondary |
363LF0000X | Nurse Practitioner - Family | 201050003NP (Oregon) | Primary |
Entity Name | Asante |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770587107 PECOS PAC ID: 0547177321 Enrollment ID: O20031219000238 |
Entity Name | Asante Three Rivers Medical Center Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801891809 PECOS PAC ID: 9931197993 Enrollment ID: O20040506000367 |
Mailing Address | Practice Location Address |
---|---|
Clinton Dale Banning, FNP Po Box 338, 133 Winnie Walker Lane, Glendale, OR 97442-0338 Ph: (541) 832-2335 | Clinton Dale Banning, FNP 500 Sw Ramsey, Grants Pass, OR 97527 Ph: (541) 472-7069 |
Ms. Catherine Chiaradonna, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1867 Williams Hwy Ste 226, Grants Pass, OR 97527 Phone: 877-672-8620 | |
Cathryn Diann Draper, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 520 Sw Ramsey Ave Ste 204, Grants Pass, OR 97527 Phone: 541-930-7223 Fax: 541-930-7221 | |
Deborah Lynn Rossel, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 Nw 6th St, Grants Pass, OR 97526 Phone: 541-916-5500 Fax: 541-916-5010 | |
Krista Fuqua, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1585 Nw Washington Blvd, Grants Pass, OR 97526 Phone: 541-474-5511 | |
Laura Lynn Johnson, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1619 Nw Hawthorne Ave Ste 204, Grants Pass, OR 97526 Phone: 541-916-8530 Fax: 541-916-8533 | |
Mona Kaahu, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1701 Nw Hawthorne Ave, Grants Pass, OR 97526 Phone: 541-471-3455 Fax: 541-471-9242 | |
Ms. Charlane A Frazier, WHCNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 160 Nw Franklin Blvd, Grants Pass, OR 97526 Phone: 541-474-2784 Fax: 541-474-0638 |