Healthcare Provider Details

I. General information

NPI: 1356406151
Provider Name (Legal Business Name): SHARON A BANKS APN C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 BROADWAY PLANNED PARENTHOOD OF SOUTHERN NJ
CAMDEN NJ
08103
US

IV. Provider business mailing address

405 HURFFVILLE CROSSKEYS RD STE 202
SEWELL NJ
08080-9344
US

V. Phone/Fax

Practice location:
  • Phone: 856-365-3519
  • Fax: 856-365-9215
Mailing address:
  • Phone: 856-589-1414
  • Fax: 856-256-5772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00068600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number26NJ00068600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: