Provider Demographics
NPI:1821556507
Name:BANKS, LYNDA KENDALL (PBT)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:KENDALL
Last Name:BANKS
Suffix:
Gender:F
Credentials:PBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 WALMSLEY BLVD APT A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-2557
Mailing Address - Country:US
Mailing Address - Phone:804-497-9716
Mailing Address - Fax:
Practice Address - Street 1:3443 WALMSLEY BLVD APT A
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-2557
Practice Address - Country:US
Practice Address - Phone:804-497-9716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA20344246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy