MEDICARE: MRS. AMIE FRANCISCA NOELISE BANNIS CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	5063	VI

General Provider Information

NPI Number	:	1376870261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMIE FRANCISCA NOELISE BANNIS CNM

Provider Business Mailing Address
First Line	:	PO BOX 7513
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00823-7513
Country	:	US
Telephone Number	:	340-778-9607
Fax Number	:	340-778-9607

Provider Business Practice Location Address
First Line	:	4007 ESTATE DIAMOND RUBY
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4435
Country	:	US
Telephone Number	:	340-772-7349
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2009
Last Update Date	:	12/02/2009

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