Provider Demographics
NPI:1023627429
Name:BANK, TRISHA KAY (FNP-C)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:KAY
Last Name:BANK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WALTER ST NE STE 501
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2521
Mailing Address - Country:US
Mailing Address - Phone:505-727-3170
Mailing Address - Fax:505-727-9590
Practice Address - Street 1:500 WALTER ST NE STE 501
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2521
Practice Address - Country:US
Practice Address - Phone:505-727-3170
Practice Address - Fax:505-727-9590
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704257441363LF0000X
NM68795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily