Individual
AMBER BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
441 N WABASH AVE, MARION, IN 46952-2612
(765) 662-4236
(765) 662-4903
Mailing address
330 N WABASH, STE G20, MARION, IN 46952-2600
(765) 660-7600
(765) 651-7313
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
28164048A
IN
363L00000X
Nurse Practitioner
28164048A
IN
363LF0000X
Family Nurse Practitioner
Primary
28164048A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001318487
ANTHEM
IN
05
—
300033906
—
IN
Enumeration date
09/10/2019
Last updated
10/20/2020
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