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LAUREN ELIZABETH BANASZAK CNM

>> Midwife, Certified Nurse >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1346817079

Individual Registrant:
 LAUREN ELIZABETH BANASZAK CNM
Gender: F
Sole Proprietor

Location and contact information for practice:
1105 BURLEYSON RD  DALTON, GA 30720-3181 US
Tel: 706-278-4640  Fax: --

Contact information for business:
1105 BURLEYSON RD  DALTON, GA 30720-3181 US
Tel: 706-278-4640  Fax: --

Registration Information:
NPI: 1346817079
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y367A00000XPhysician Assistants & Advanced Practice Nursing Providers
Midwife, Certified Nurse
GARN301551

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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