Healthcare Provider Details

I. General information

NPI: 1073126439
Provider Name (Legal Business Name): ASHLEY BANKS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 FRIENDSHIP RD STE 100
BRASELTON GA
30517-5638
US

IV. Provider business mailing address

1930 BRANNAN RD
MCDONOUGH GA
30253-4310
US

V. Phone/Fax

Practice location:
  • Phone: 678-205-8387
  • Fax: 678-808-1039
Mailing address:
  • Phone: 678-284-4040
  • Fax: 678-284-4076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP227128
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: