Provider Demographics
NPI:1487959367
Name:BANKS, XYLINA YVETTE (LVN)
Entity type:Individual
Prefix:MS
First Name:XYLINA
Middle Name:YVETTE
Last Name:BANKS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13930 S BUDLONG AVE
Mailing Address - Street 2:APT A
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-2257
Mailing Address - Country:US
Mailing Address - Phone:310-303-9196
Mailing Address - Fax:
Practice Address - Street 1:13930 S BUDLONG AVE
Practice Address - Street 2:APT A
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-2257
Practice Address - Country:US
Practice Address - Phone:310-303-9196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA205169164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse