Individual
CAROL ANN BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
420 W FOURTH STREET, SUITE 100-A, MISHAWAKA, IN 46544-1948
(574) 252-0309
(574) 472-3694
Mailing address
PO BOX 6489, SOUTH BEND, IN 46660-6489
(574) 472-6700
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
28120528A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200068990A
—
IN
Enumeration date
07/20/2007
Last updated
05/21/2009
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