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Organization
MOANA WELLNESS PRACTICE
Active
Organization
MOANA WELLNESS PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BANGURA (FNP)
(123) 456-7890
Entity
Organization
Contact information
Practice address
2019 RAVENWOOD RD, FOLCROFT, PA 19032-1508
(123) 456-7890
Mailing address
2019 RAVENWOOD RD, FOLCROFT, PA 19032-1508
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/13/2025
Last updated
10/23/2025
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