MEDICARE: TEAIRA NICOLE 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	163WH0200X	Home Health Registered Nurse	RN.462533	OH
2	163WH1000X	Hospice Registered Nurse	RN.462533	OH
3	163WP0000X	Pain Management Registered Nurse	RN.462533	OH
4	163WC0400X	Case Management Registered Nurse	RN.462533	OH
5	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	RN.462533	OH
6	163W00000X	Registered Nurse	RN.462533	OH
7	163WW0000X	Wound Care Registered Nurse	RN.462533	OH

General Provider Information

NPI Number	:	1346197795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEAIRA NICOLE BANKS

Provider Business Mailing Address
First Line	:	3080 SANDRIDGE AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-6845
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3080 SANDRIDGE AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-6845
Country	:	US
Telephone Number	:	614-512-7063
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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Directions to “ TEAIRA NICOLE BANKS ” Practice Location

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