Provider Demographics
NPI:1053010835
Name:BANKS, TRACY M (DNP RN)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:M
Last Name:BANKS
Suffix:
Gender:F
Credentials:DNP RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 VILLAGE BLVD # 288
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1803
Mailing Address - Country:US
Mailing Address - Phone:561-420-2530
Mailing Address - Fax:
Practice Address - Street 1:689 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-3706
Practice Address - Country:US
Practice Address - Phone:561-420-2530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services