Provider Demographics
NPI:1922585462
Name:GITHINJI, BANIS (FNP)
Entity Type:Individual
Prefix:
First Name:BANIS
Middle Name:
Last Name:GITHINJI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11101 GEORGIA AVE UNIT 559
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-7607
Mailing Address - Country:US
Mailing Address - Phone:240-575-0437
Mailing Address - Fax:
Practice Address - Street 1:11101 GEORGIA AVE UNIT 559
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-7607
Practice Address - Country:US
Practice Address - Phone:240-575-0437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR213835363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily