Elizabeth Banda, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

74771 Issued in OK

Practice address

500 S Broadway St
Ste B
Poteau, OK 74953-3819

Phone

(918) 208-7497

Fax

(918) 208-7687

NPI assigned

Jun 20, 2014

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wildhorse Family Practice & Urgent Care

  • Health Service Clinic/Center
  • Sallisaw, OK
  • NPI 1881931509
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 16, 2017.

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1851705552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S BROADWAY ST",
            "address_2": "STE B",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749533819",
            "telephone_number": "918-208-7497",
            "fax_number": "918-208-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S BROADWAY ST",
            "address_2": "STE B",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749533819",
            "telephone_number": "918-208-7497",
            "fax_number": "918-208-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDA",
        "first_name": "ELIZABETH",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-20",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "74771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200597420A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorri Ellen Baker, P.T.
• Michele Baker
• Ashley Baldwin
• Ferrell Lace Balentine, B.A.
• Lauren Eva Ball, PT
• Laurie Bandy
• Marilyn Bandy
• Michelle L Barker, PTA
• Benjamin Jackson Barnes, BHRS
• Ross Barnhart

• All providers in Poteau, OK
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.