Carol Ann Banks, R.N.
Individual provider Active NPI Case Management Registered Nurse · Mishawaka, IN
NPI 1295935880 · NPPES record last updated May 21, 2009
Key facts
- NPI
- 1295935880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Management Registered Nurse 163WC0400X
- License
- 28120528A (IN)
- Practice address
- 420 W Fourth Street
Suite 100-a
Mishawaka, IN 46544-1948 - Phone
- (574) 252-0309
- Fax
- (574) 472-3694
- NPI assigned
- Jul 20, 2007
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28120528A | IN | MD | Case Management Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 28120528A | IN | Yes |
Addresses
Primary practice location
420 W Fourth Street
Suite 100-a
Mishawaka, IN 46544-1948
Mailing address
PO Box 6489
South Bend, IN 46660-6489
Phone (574) 472-6700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200068990A | Medicaid | IN |
Other providers in Mishawaka, IN
- Jean Bahu
- Sara Bajuyo
- Diana Bakia
- Eusebia Balderas
- Robert Balliet
- Latisha Banks
- Olivia Larren Banks
- Jialin Bao
- Jody M Barber
- Lachelle L Barnett
All providers in Mishawaka, IN · Case Management Registered Nurse in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2009. 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.