Healthcare Provider Details

I. General information

NPI: 1811054661
Provider Name (Legal Business Name): LISA C. BANKS-WILLIAMS APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GEORGIA AVE NW WRAMC WARD 53 PSYCHIATRIC CONTINUITY SERVICES
WASHINGTON DC
20307-0003
US

IV. Provider business mailing address

8901 WISCONSIN AVE WRAMC WARD 53 PSYCHIATRIC CONTINUITY SERVICES
BETHESDA MD
20889-0004
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-1553
  • Fax: 202-782-2306
Mailing address:
  • Phone: 301-400-2104
  • Fax: 301-400-2920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN51079
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: