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NPI Code Detail

MEDICARE: MRS. JESSICA BANKS

MEDICARE: MRS. JESSICA 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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1972913341
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA BANKS
Provider Business Mailing Address
First Line : PO BOX 8356
Second Line :
City : SPRING CREEK
State : NV
Zip : 89815-0006
Country : US
Telephone Number : 775-340-9873
Fax Number :
Provider Business Practice Location Address
First Line : 6889 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-4687
Country : US
Telephone Number : 702-434-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2014
Last Update Date : 05/06/2014

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Directions to “ MRS. JESSICA BANKS ” Practice Location

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