Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | 34293 | SC |
Y | 207RI0200X | Infectious Disease | 41845 | KY |
NPI | 1083836399 |
---|---|
Provider Name | Dr. Andrea Banks |
First Address | Lexington, KY 40503-1488 |
Second Address | Lexington, KY 40503-1488 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 09/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009910453 | (05) | AL |
009911114 | (05) | AL |
051541775 | BLUE CROSS (01) | AL |
051541776 | BLUE CROSS (01) | AL |