Provider Demographics
NPI:1598392979
Name:BANKS, MICHAELA SKYLAR
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:SKYLAR
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 1:2001 TULANE AVE FL DT2
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2249
Mailing Address - Country:US
Mailing Address - Phone:504-702-2287
Mailing Address - Fax:
Practice Address - Street 1:2001 TULANE AVE FL DT2
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2249
Practice Address - Country:US
Practice Address - Phone:504-702-2287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA331611207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program