Provider Demographics
NPI:1679378061
Name:BANKS, JARED ISAAC
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:ISAAC
Last Name:BANKS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S MAPLE ST APT 211
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1611
Mailing Address - Country:US
Mailing Address - Phone:333-414-6713
Mailing Address - Fax:
Practice Address - Street 1:315 S MAPLE ST APT 211
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1611
Practice Address - Country:US
Practice Address - Phone:333-414-6713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant