Ms Jacquelyn Lou Banasik, MN ARNP is a
Nurse Practitioner - Family physician based in Spokane, Washington. Ms Jacquelyn Lou Banasik is licensed to practice in Washington (license number AP30003996) and her current practice location is 103 E Spokane Falls Blvd, Nurs 447, Spokane, Washington. She can be reached at her office (for appointments etc.) via phone at
(509) 324-7269.
NPI number for Ms Jacquelyn Lou Banasik is 1174518021 and her current mailing address is Po Box 1495, Nurs 447, Spokane, Washington. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1174518021.
Physician's Profile
| Full Name | Ms Jacquelyn Lou Banasik |
|---|
| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
|---|
| Location | 103 E Spokane Falls Blvd, Spokane, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1174518021
- Provider Enumeration Date: 09/16/2005
- Last Update Date: 05/22/2018
Medical Identifiers
Medical identifiers for Ms Jacquelyn Lou Banasik such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174518021 | NPI | - | NPPES |
| 9623026 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | AP30003996 (Washington) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | AP30003996 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Jacquelyn Lou Banasik is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Jacquelyn Lou Banasik, MN ARNP
Po Box 1495, Nurs 447,
Spokane, WA 99210-1495
Ph: (509) 324-7269 | Ms Jacquelyn Lou Banasik, MN ARNP
103 E Spokane Falls Blvd, Nurs 447,
Spokane, WA 99202
Ph: (509) 324-7269 |
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