Healthcare Provider Details

I. General information

NPI: 1417305921
Provider Name (Legal Business Name): TAMEEKA BANKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 OLD YORK RD
PHILADELPHIA PA
19141-3018
US

IV. Provider business mailing address

913 GILBERT RD
CHELTENHAM PA
19012-1927
US

V. Phone/Fax

Practice location:
  • Phone: 215-456-6860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN524944L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: