Provider Demographics
NPI:1639666217
Name:BANKS, KAREN MICHELE (RN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MICHELE
Last Name:BANKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9902 SPANISH OAK WAY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3706
Mailing Address - Country:US
Mailing Address - Phone:140-430-9257
Mailing Address - Fax:
Practice Address - Street 1:9902 SPANISH OAK WAY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-3706
Practice Address - Country:US
Practice Address - Phone:140-430-9257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR214045163WH0200X
DCRN1037042163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health