Individual
SAMANTHA ANN BANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2313 N ROCKTON AVE, ROCKFORD, IL 61103-3618
(815) 964-2200
(815) 965-7722
Mailing address
15355 E DEES DR, MONROE CENTER, IL 61052-9747
(815) 543-0545
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209.019754
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277002340
IL
Other
Enumeration date
08/06/2019
Last updated
01/10/2026
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