Provider Demographics
NPI:1295808921
Name:BANK, PAULA A (MD, PHD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:A
Last Name:BANK
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-5429
Mailing Address - Country:US
Mailing Address - Phone:608-782-7300
Mailing Address - Fax:
Practice Address - Street 1:1836 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-5429
Practice Address - Country:US
Practice Address - Phone:608-782-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44320-0202084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI97596Medicaid
390821863005OtherTRICARE-HEALTH NET
WI34233900Medicaid
MN610002300Medicaid
IA2558981Medicaid
WI39082186310OtherUNITY HEALTH INSURANCE
MNHP66977OtherHEALTHPARTNERS
MNHP66977OtherHEALTHPARTNERS
WI000784005Medicare PIN
WI000784003Medicare PIN
WI97596Medicaid