Healthcare Provider Details

I. General information

NPI: 1245150606
Provider Name (Legal Business Name): MARIE ANNETTE BANKS AA. HHA,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

993 SIMPSON DITCH RD
ELIZABETH CITY NC
27909-7681
US

IV. Provider business mailing address

993 SIMPSON DITCH RD
ELIZABETH CITY NC
27909-7681
US

V. Phone/Fax

Practice location:
  • Phone: 252-333-9827
  • Fax:
Mailing address:
  • Phone: 252-333-9827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number21519595
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: