Provider Demographics
NPI:1558621672
Name:BANKS, ZAKIA DOMINIQUE
Entity Type:Individual
Prefix:
First Name:ZAKIA
Middle Name:DOMINIQUE
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 1:6519 LANDOVER RD
Mailing Address - Street 2:#202
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1424
Mailing Address - Country:US
Mailing Address - Phone:240-280-4613
Mailing Address - Fax:
Practice Address - Street 1:6519 LANDOVER RD
Practice Address - Street 2:#202
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1424
Practice Address - Country:US
Practice Address - Phone:240-280-4613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDB520974149096374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide