| Doctor Name: | MS. SHERVONNE EVETTE BANKS |
| NPI Number: | 1033398003 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSG |
| License Number: | 112160 |
| Business Practice Address: | 11 Pine Lake Ct Hampton, VA - 236691200 |
| Business Phone Number: | 7572407928 |
| Business Fax Number: | 7572570017 |
| Mailing Address: | 4410 Claiborne Sq E Ste 334, HAMPTON |
| State: | VA |
| Postal Code: | 236662074 |
| Phone Number: | 7572407928 |
| Fax Number: | 7572570017 |
| NPI Enumeration Date: | 10/26/2007 |
| NPI Last Update Date: | 01/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 305S00000X |
| License Number: | 112160 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Point of Service |
| Taxonomy Specialization: | |
| Taxonomy Definition: | This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |