Provider Demographics
NPI:1124141437
Name:BANKS, NANCY M
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:M
Last Name:BANKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2861 N COUNTY ROAD 11
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-9104
Mailing Address - Country:US
Mailing Address - Phone:419-618-1622
Mailing Address - Fax:
Practice Address - Street 1:2861 N COUNTY ROAD 11
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-9104
Practice Address - Country:US
Practice Address - Phone:419-618-1622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN246094163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management