Healthcare Provider Details

I. General information

NPI: 1972191344
Provider Name (Legal Business Name): BEATRICE KAMAH BANKS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2021
Last Update Date: 01/01/2021
Certification Date: 01/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9470 ANNAPOLIS RD STE 402
LANHAM MD
20706-3059
US

IV. Provider business mailing address

11013 SPYGLASS HL
BOWIE MD
20721-2345
US

V. Phone/Fax

Practice location:
  • Phone: 240-486-6319
  • Fax:
Mailing address:
  • Phone: 301-341-1987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR195414
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: