Provider Demographics
NPI:1821437096
Name:BANKS, TERI RENEE
Entity Type:Individual
Prefix:MS
First Name:TERI
Middle Name:RENEE
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 1:716 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-3723
Mailing Address - Country:US
Mailing Address - Phone:530-366-2496
Mailing Address - Fax:
Practice Address - Street 1:716 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3723
Practice Address - Country:US
Practice Address - Phone:530-366-2496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide