QUEENTA BANACK DO
NPI 1235832692
Nurse Practitioner - Family in Fulton, MD

Q: What is Queenta Banack's NPI number?

The NPI number for Queenta Banack is 1235832692. It was assigned to this individual provider in the NPPES registry on March 24, 2023.

Q: What is Queenta Banack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Queenta Banack was last updated on March 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 24, 2023

8115 MAPLE LAWN BLVD STE 109, FULTON, MD 20759(301) 404-8724 Get Directions Write a Review

NPPES record last updated: March 24, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Queenta Banack Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

QUEENTA BANACK DO (NPI 1235832692) is an individual family provider in Fulton, Maryland, licensed in Virginia (0024186737) and active in the NPI registry since March 2023.

NPPES Registry Identity

NPI1235832692

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameQUEENTA BANACKCredential: DO

Location Address8115 MAPLE LAWN BLVD STE 109Fulton, MD 20759-2681

Mailing Address8115 Maple Lawn Blvd Ste 109Fulton, MD 20759-2681 · (301) 404-8724

Phone(301) 404-8724

Sole ProprietorNo

Enumeration DateMarch 24, 2023

NPPES CertifiedMarch 24, 2023

✔ NPI 1235832692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in VA · 0024186737

8115 MAPLE LAWN BLVD STE 109, Fulton, MD 20759

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Queenta Banack's NPI number?

The NPI number for Queenta Banack is 1235832692. It was assigned to this individual provider in the NPPES registry on March 24, 2023.

Where is Queenta Banack located?

Queenta Banack practices at 8115 Maple Lawn Blvd Ste 109, Fulton, MD 20759. The listed phone number is (301) 404-8724.

What is Queenta Banack's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Queenta Banack was last updated on March 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.