Provider Demographics
NPI:1215658802
Name:BANKS, DELTA L
Entity type:Individual
Prefix:
First Name:DELTA
Middle Name:L
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 1:63 HARRY S TRUMAN DR APT 13
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1028
Mailing Address - Country:US
Mailing Address - Phone:202-904-4426
Mailing Address - Fax:
Practice Address - Street 1:612 46TH PL SE APT 13
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-7829
Practice Address - Country:US
Practice Address - Phone:202-904-4426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant