Individual
DEANNA J BANUSKEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5133
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
064174-21
NH
363LP0200X
Pediatric Nurse Practitioner
Primary
064174-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30348918
—
NH
Enumeration date
05/18/2011
Last updated
02/03/2020
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