Individual
DIANE RENEE BANIGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3033 EXCELSIOR BLVD STE 585, MINNEAPOLIS, MN 55416-6400
(612) 345-5920
(844) 562-6828
Mailing address
3033 EXCELSIOR BLVD STE 585, MINNEAPOLIS, MN 55416-6400
(612) 345-5920
(844) 562-6828
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
152803-1
MN
367A00000X
Advanced Practice Midwife
Primary
R152803-1
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-04617
MEDICA
MN
01
—
088H5BA
BCBS
MN
01
—
182098
UCARE
MN
05
—
238495700
—
MN
01
—
923911045942
PREFERRED ONE
MN
01
—
HP58089
HEALTH PARTNERS
MN
Enumeration date
03/24/2006
Last updated
03/17/2018
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