Individual
DALE L. BANKS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
441 WALL BLVD, GRETNA, LA 70056-7723
(504) 371-6550
Mailing address
441 WALL BLVD, GRETNA, LA 70056-7723
(504) 371-6550
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP07146
LA
363LF0000X
Family Nurse Practitioner
RN119373
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08327872
—
MS
05
—
2333801
—
LA
Enumeration date
05/20/2013
Last updated
10/28/2014
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