Autumn Banks
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Waterloo, IA
NPI 1174457709 · NPPES record last updated Jun 9, 2026
Key facts
- NPI
- 1174457709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 17599 (CT)
- Practice address
- 4000 University Ave
Waterloo, IA 50701-5640 - Phone
- (319) 235-1230
- NPI assigned
- Jun 9, 2026
- 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)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 17599 | CT | Yes |
Addresses
Primary practice location
4000 University Ave
Waterloo, IA 50701-5640
Mailing address
62 Cherry LN
Perryville, MD 21903-2036
Other providers in Waterloo, IA
- Jane Marie Baker
- Katie R Baker
- Chelsey Elaine Ballard
- Katherine Marie Ballenger
- Erika Bandilla
- Renu Bansal
- Beth Barber
- Renee Barbu
- Andrew Barden
- Beth Bardonner
All providers in Waterloo, IA · Psychiatric/Mental Health Nurse Practitioner in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2026. 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.