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Individual

EMMA J. BANWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
800 WEST AVENUE SOUTH, LA CROSSE, WI 54601
(608) 782-9760
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(608) 785-0940

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
200340596RN
OR
363L00000X
Nurse Practitioner
Primary
164299
WI
363LF0000X
Family Nurse Practitioner
3490
WI

Other

Enumeration date
07/28/2007
Last updated
07/25/2022
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