Provider Demographics
NPI:1194402578
Name:GBANYA, WEYATTA (CNA)
Entity type:Individual
Prefix:
First Name:WEYATTA
Middle Name:
Last Name:GBANYA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 26TH ST W APT 2202
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-5297
Mailing Address - Country:US
Mailing Address - Phone:248-924-0730
Mailing Address - Fax:
Practice Address - Street 1:3710 26TH ST W APT 2202
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-5297
Practice Address - Country:US
Practice Address - Phone:248-924-0730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide