Susan Kay Banks, CNP
Individual provider Active NPI Registered Nurse · Mountainair, NM
NPI 1013978006 · NPPES record last updated Oct 28, 2013
Key facts
- NPI
- 1013978006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- R22221 (NM)
- Practice address
- 105 East Pinon Street
Mountainair, NM 87036 - Phone
- (505) 847-2271
- NPI assigned
- Mar 29, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R22221 | NM | Yes |
Addresses
Primary practice location
105 East Pinon Street
Mountainair, NM 87036
Mailing address
PO Box 787
Mountainair, NM 87036-0787
Phone (505) 847-2271
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10002813 | Other | NM | LOVELACE HEALTH PLAN |
| 850206810 | Other | NM | TRICARE |
| PROVP11807 | Other | NM | MOLINA HEALTHCARE |
| 93567 | Medicaid | NM | |
| NM006E47 | Other | NM | BLUECROSS BLUESHIELD OF NEW MEXICO |
Other providers in Mountainair, NM
- Lori Alison Autrey
- Marie Justine Cadieux
- City of Mountainair
- Tanna M Corral
- Laurie A Engelhard
- Frances Roggen, P.T., P.a.
All providers in Mountainair, NM · Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.