Individual
LAUREN ELIZABETH BANASZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1105 BURLEYSON RD, DALTON, GA 30720-3181
(706) 278-4640
Mailing address
1105 BURLEYSON RD, DALTON, GA 30720-3181
(706) 278-4640
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN301551
GA
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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