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Individual

IDRISS FADIKA BANGURA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
294 PARK RD, WESTERVILLE, OH 43081-5680
(614) 260-4849
Mailing address
294 PARK RD, WESTERVILLE, OH 43081-5680
(614) 260-4849

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN356256
OH
163WC1500X
Community Health Registered Nurse
RN356256
OH

Other

Enumeration date
02/24/2010
Last updated
02/24/2010
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