Individual
MR. BRIAN STEPHEN BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
28 RIVERSIDE DR STE 260, PEMBROKE, MA 02359-4947
(508) 993-3000
(508) 993-3009
Mailing address
28 RIVERSIDE DR STE 260, PEMBROKE, MA 02359-4947
(781) 427-7070
(781) 427-7071
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN2291563
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2291563
MA
Other
Enumeration date
07/09/2015
Last updated
07/07/2020
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