Individual
KAITLYN R BANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1005 DIVISION ST, PRESCOTT, AZ 86301-1601
(928) 776-8428
Mailing address
1005 DIVISION ST, PRESCOTT, AZ 86301-1601
(928) 776-8428
(833) 449-5321
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
011238
AZ
207V00000X
Obstetrics & Gynecology Physician
5101027374
MI
Other
Enumeration date
04/22/2019
Last updated
12/03/2024
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