Individual
YARIA ISABELLA BANGURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5421 PENN AVE N, MINNEAPOLIS, MN 55430-2943
(612) 812-4744
Mailing address
625 SNELLING AVE N, SAINT PAUL, MN 55104-2878
(651) 363-3111
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP4862
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
CNP4862
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235680836
—
MN
Enumeration date
10/18/2016
Last updated
02/03/2025
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