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General NPI Number Information
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NPI Number | 1740903004
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Entity Type | Individual
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Provider Name | RABIATU BANGURA
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Gender | Female
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Dates
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Enumeration Date | 09/22/2022
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 420 CHINAQUIN ROUND ROAD
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City | ANNAPOLIS
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State | MD
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Zip | 21401
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Country | US
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Telephone | 301-793-1775
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Fax |
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Provider Business Mailing Address
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Address Line | 15614 MEWS CT
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City | LAUREL
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State | MD
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Zip | 20707-3311
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Country | US
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Telephone | 301-793-1775
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R222991
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License Number State | MD
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