Individual
JESSICA BANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 LATHROP AVE, NORWICH, CT 06360-2308
(860) 204-0883
Mailing address
2 LATHROP AVE, NORWICH, CT 06360-2340
(860) 608-3042
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9969
CT
Other
Enumeration date
09/07/2021
Last updated
05/27/2022
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