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General NPI Number Information
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NPI Number | 1275332371
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Entity Type | Individual
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Provider Name | SAMANTHA BANKS MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 1240 SIGMAN RD NW STE 103
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City | CONYERS
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State | GA
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Zip | 30012-3934
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Country | US
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Telephone | 404-965-0633
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 SIGMAN RD NW STE 103
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City | CONYERS
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State | GA
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Zip | 30012-3934
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Country | US
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Telephone | 404-857-4788
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP251148
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License Number State | GA
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