Provider Demographics
NPI:1245118306
Name:BANKS, TRISTEN D
Entity type:Individual
Prefix:
First Name:TRISTEN
Middle Name:D
Last Name:BANKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PLANTATION RIDGE DR APT D
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-5282
Mailing Address - Country:US
Mailing Address - Phone:229-474-6933
Mailing Address - Fax:888-815-1851
Practice Address - Street 1:100 PLANTATION RIDGE DR APT D
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-5282
Practice Address - Country:US
Practice Address - Phone:229-474-6933
Practice Address - Fax:888-815-1851
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN287518363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty