Individual
MRS. AMY M BANASZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
325 E FONTANERO ST, COLORADO SPRINGS, CO 80907
(719) 636-3829
(719) 633-8571
Mailing address
325 E FONTANERO ST, COLORADO SPRINGS, CO 80907
(719) 636-3829
(719) 633-8571
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-990213
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16922778
—
CO
Enumeration date
09/23/2011
Last updated
11/07/2013
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