MEDICARE: JOSEPH M. BANKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	3206	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184031726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH M. BANKS

Provider Business Mailing Address
First Line	:	104 MCCRAY LN
Second Line	:
City	:	MILLSTONE
State	:	KY
Zip	:	41838-8922
Country	:	US
Telephone Number	:	606-634-8196
Fax Number	:

Provider Business Practice Location Address
First Line	:	756 HIGHWAY 2034
Second Line	:
City	:	WHITESBURG
State	:	KY
Zip	:	41858-7500
Country	:	US
Telephone Number	:	606-634-8196
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOSEPH M BANKS
Credential	:	APRN
Telephone Number	:	606-634-8196

Provider Enumeration Date	:	07/15/2014
Last Update Date	:	10/09/2014

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Directions to “JOSEPH M. BANKS ” Practice Location

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