Individual
MRS. STEPHANIE EILEEN BANASIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADULT NURSE PRACTITI
Contact information
Practice address
10200 FORD AVE. STE. 101, RICHMOND HILL, GA 31324
(912) 459-6446
(912) 445-5781
Mailing address
1175 COOK RD, STE 115, ORANGEBURG, SC 29118-8201
(803) 531-2677
(803) 531-6137
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN220937
GA
Other
Enumeration date
05/12/2015
Last updated
08/02/2016
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