Individual
TRESHA DANYELE BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
144 BILL CARRUTH PKWY STE 4200, HIRAM, GA 30141-3819
(678) 324-4444
Mailing address
11361 AZALEA TRL, HAMPTON, GA 30228-3230
(404) 245-2789
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN251023
GA
363LA2100X
Acute Care Nurse Practitioner
RN251023
GA
Other
Enumeration date
09/10/2019
Last updated
08/07/2024
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