Provider Demographics
NPI:1235954140
Name:BANKS, SYLVER J
Entity type:Individual
Prefix:
First Name:SYLVER
Middle Name:J
Last Name:BANKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 STONEBRIDGE PARK CIR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-9048
Mailing Address - Country:US
Mailing Address - Phone:470-808-8552
Mailing Address - Fax:
Practice Address - Street 1:841 STONEBRIDGE PARK CIR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-9048
Practice Address - Country:US
Practice Address - Phone:470-808-8552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0028852033376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide