Healthcare Provider Details

I. General information

NPI: 1134595416
Provider Name (Legal Business Name): REWA A BANKS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5378 COX SMITH RD STE D
MASON OH
45040-6803
US

IV. Provider business mailing address

6647 BARBERRY LN APT A
LIBERTY TOWNSHIP OH
45044-1230
US

V. Phone/Fax

Practice location:
  • Phone: 513-935-3980
  • Fax: 513-880-0554
Mailing address:
  • Phone: 419-234-2590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP19414
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: