Individual
FANTA BANGURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2512 24TH ST NE, WASHINGTON, DC 20018-2126
(202) 832-8340
Mailing address
9404 BALD HILL RD, BOWIE, MD 20721-2872
(301) 523-6519
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
A00193096
MD
Other
Enumeration date
03/08/2023
Last updated
03/08/2023
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