Provider Demographics
NPI:1346906898
Name:BANKS, TIFFANY (ND, FNP-BC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:BANKS
Suffix:
Gender:F
Credentials:ND, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 MILLERSBURG RD
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2145
Mailing Address - Country:US
Mailing Address - Phone:859-592-4992
Mailing Address - Fax:859-788-6577
Practice Address - Street 1:416 MILLERSBURG RD
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2145
Practice Address - Country:US
Practice Address - Phone:859-592-4992
Practice Address - Fax:859-788-6577
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1147517163W00000X
172P00000X
KY3017535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No172P00000XOther Service ProvidersNaprapath