Provider Demographics
NPI:1780889899
Name:BANKE, DAWN JENNIFER (ARNP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:JENNIFER
Last Name:BANKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:JENNIFER
Other - Last Name:GUMIENY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN FNP
Mailing Address - Street 1:4217 S HOPKINS AVE
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-6605
Mailing Address - Country:US
Mailing Address - Phone:321-486-7654
Mailing Address - Fax:321-463-3804
Practice Address - Street 1:4217 S HOPKINS AVE
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-6605
Practice Address - Country:US
Practice Address - Phone:321-486-7654
Practice Address - Fax:321-463-3804
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9192211363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily