Provider Demographics
NPI:1437436318
Name:BANKS, TAMARA MICHELE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:MICHELE
Last Name:BANKS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 UNION AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-4316
Mailing Address - Country:US
Mailing Address - Phone:901-726-1161
Mailing Address - Fax:
Practice Address - Street 1:2225 UNION AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-4316
Practice Address - Country:US
Practice Address - Phone:901-726-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily