MEDICARE: JANNEL BANKS PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	870541	NV

General Provider Information

NPI Number	:	1962274506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANNEL BANKS PMHNP

Provider Business Mailing Address
First Line	:	4029 DEAN MARTIN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4138
Country	:	US
Telephone Number	:	702-848-2256
Fax Number	:

Provider Business Practice Location Address
First Line	:	1804 ASHLEY LYNN AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-1806
Country	:	US
Telephone Number	:	702-480-9040
Fax Number	:

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

Provider Enumeration Date	:	10/26/2023
Last Update Date	:	10/30/2023

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