Individual
MS. KATHLEEN LOUISE BANKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4735 OGLETOWN STANTON RD STE 2103, NEWARK, DE 19713-8000
(302) 623-4410
(302) 623-4415
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6421
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C5-0012267
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06171
LICENSE
MD
Enumeration date
05/18/2016
Last updated
08/05/2025
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