Bannon, Annika
Bannon, Annika is an individual health care provider with primary practice located at 80 B Veterans Blvd , Acoma NM 87034-8704. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bannon, Annika can be contacted via phone (505) 552-5300.Contact Information
Primary practice address
80 B Veterans Blvd
Acoma NM 87034-8704
Phone: (505) 552-5300
Fax: (505) 552-5490
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 4301506218 | Michigan |
Profile Details
| NPI number | 1508326471 |
|---|---|
| LBN Legal business name | Bannon, Annika |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 25th, 2019 |
| Last updated | Jan 5th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508326471 | NPPES |
| New Mexico | MEDICAID | H3451 |
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