Healthcare Provider Details

I. General information

NPI: 1447185327
Provider Name (Legal Business Name): JANE ANYU-BANGANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7946 VANITY FAIR DR
GREENBELT MD
20770-3347
US

IV. Provider business mailing address

7946 VANITY FAIR DR
GREENBELT MD
20770-3347
US

V. Phone/Fax

Practice location:
  • Phone: 202-250-4007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberR135481
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberR135481
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: