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LAUREN ELIZABETH BANASZAK CNM
>> Midwife, Certified Nurse >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1346817079
Individual Registrant: LAUREN ELIZABETH BANASZAK CNM
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
1105 BURLEYSON RD DALTON, GA 30720-3181 US
Tel: 706-278-4640 Fax: --
Tel: 706-278-4640 Fax: --
Contact information for business:
1105 BURLEYSON RD DALTON, GA 30720-3181 US
Tel: 706-278-4640 Fax: --
Tel: 706-278-4640 Fax: --
Registration Information:
NPI: 1346817079
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers Midwife, Certified Nurse | GA | RN301551 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
