Provider Demographics
NPI:1407307085
Name:BANKER, ROSANNA (ND)
Entity Type:Individual
Prefix:DR
First Name:ROSANNA
Middle Name:
Last Name:BANKER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:ROSIE
Other - Middle Name:
Other - Last Name:BANKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:221 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-2728
Mailing Address - Country:US
Mailing Address - Phone:541-241-7077
Mailing Address - Fax:877-917-2542
Practice Address - Street 1:221 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-2728
Practice Address - Country:US
Practice Address - Phone:541-241-7077
Practice Address - Fax:877-917-2542
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16-1578175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No175F00000XOther Service ProvidersNaturopath