Provider Demographics
NPI:1861109795
Name:BANKS, KATHERINE BERRYMAN (MED)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:BERRYMAN
Last Name:BANKS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3823 GALLATIN PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-2689
Mailing Address - Country:US
Mailing Address - Phone:859-533-1520
Mailing Address - Fax:
Practice Address - Street 1:1033 W GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3447
Practice Address - Country:US
Practice Address - Phone:615-262-6981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health