Provider Demographics
NPI:1144933508
Name:BANKS, JAKAI (EMT I)
Entity type:Individual
Prefix:MR
First Name:JAKAI
Middle Name:
Last Name:BANKS
Suffix:
Gender:M
Credentials:EMT I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 HEATON DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-0224
Mailing Address - Country:US
Mailing Address - Phone:678-965-3460
Mailing Address - Fax:
Practice Address - Street 1:45 HEATON DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-0224
Practice Address - Country:US
Practice Address - Phone:678-965-3460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAI36519146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate