Basic Information
| Provider Information | |||||||||
| NPI: | 1902980303 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BANKS | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20037 WHITESVILLE RD | ||||||||
| Address2: | |||||||||
| City: | MILLSBORO | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199664108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3022387731 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | MARYLAND ACCESS PROGRAM | ||||||||
| Address2: | 4767 SNOW HILL ROAD | ||||||||
| City: | SNOW HILL | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21863 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106329925 | ||||||||
| FaxNumber: | 4106329902 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC1500X | LI0029600 | DE | Y | Nursing Service Providers | Registered Nurse | Community Health |
No ID Information.