Individual
DAVID BANICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8202
Mailing address
9555 76TH ST, PLEASANT PRAIRIE, WI 53158-1984
(262) 577-8202
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
230971-30
WI
363LF0000X
Family Nurse Practitioner
Primary
F05250443
WI
Other
Enumeration date
02/12/2025
Last updated
06/19/2025
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