MS. JACQUELYN LOU BANASIK


Address: 103 E Spokane Falls Blvd, Nurs 447, Spokane, WA 99202
Phone: 5093247269

MS. JACQUELYN LOU BANASIK (NPI# 1174518021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174518021
Entity Type Individual
Full Name MS. JACQUELYN LOU BANASIK
Credential MN ARNP
Practice Address 103 E Spokane Falls Blvd
Nurs 447
Spokane
WA 99202
Mailing Address Po Box 1495
Nurs 447
Spokane
WA 99210-1495
Practice Telephone 5093247269
Practice Fax Number 5093247341
Mailing Telephone 5093247269
Mailing Fax Number 5093247341
Enumeration Date 2005-09-16
Last Update Date 2018-05-22
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine AP30003996 WA Allopathic & Osteopathic Physicians
Y 363LF0000X Nurse Practitioner
Specialization: Family
AP30003996 WA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WA 9623026 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
107 S Division St, Spokane, WA 992021510 5098384651 5093632762

Office Location

Street Address 103 E SPOKANE FALLS BLVD
NURS 447
City SPOKANE
State WA
Zip Code 99202

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609330992 Bryan Donald Cress Nurse Practitioner 9425 N Nevada St Ste 300, Spokane, WA 99218-1286 2019-01-30
1922570373 Cassandra Lynn Prewitt Nurse Practitioner 400 E 5th Ave # 1, Spokane, WA 99202-1334 2018-12-26
1447743117 Matthew Kilgore Nurse Practitioner 707 W 7th Ave Ste 290, Spokane, WA 99204-2833 2018-06-07
1902252505 Richard D Ervin Nurse Practitioner 1820 W Pepper Ln, Spokane, WA 99218-2759 2016-05-12
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1427427178 Kristen Bolling Nurse Practitioner 6518 E Lyons Ave, Spokane, WA 99217-9700 2015-09-23
1063897965 Julia Wolf Nurse Practitioner 9631 N Nevada St Ste 202, Spokane, WA 99218-1197 2015-07-21
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Competitor

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City SPOKANE
Zip Code 99202

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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