Dallas Banner, NP
Nurse Practitioner in Raleigh, NC. Individual provider (NPI-1).
NPI number1033763537
StatusActive
Last updated in NPPESOct 7, 2024
Details
- NPI
- 1033763537
- Entity type
- Individual (NPI-1)
- Name
- Dallas Banner
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 1, 2019
- Certification date
- Oct 7, 2024
- Last updated
- Oct 7, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 5012314 | NC | Yes |
| 163WU0100X | Registered Nurse, Urology | 259156 | NC | |
| 208800000X | Urology | 5012314 | NC |
Practice location
3000 New Bern AveRaleigh, NC 27610-1231
Phone 919-350-8114
Mailing address
5115 Park Rd Apt 302Charlotte, NC 28209-3820
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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