NPI Profile for JACQUELYN L BANASIK in SPOKANE, WA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice |
| NPI # | 1174518021 |
|
| Status | Active | |
| Credentials | MN ARNP | |
| Entity | Individual | |
| Enumeration date | 09/16/2005 | |
| Last updated | 05/22/2018 - About 8 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JACQUELYN L BANASIK
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