Provider Demographics
NPI:1427246560
Name:BANGURA, RASHIDA (LPN)
Entity type:Individual
Prefix:
First Name:RASHIDA
Middle Name:
Last Name:BANGURA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5498 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-3134
Mailing Address - Country:US
Mailing Address - Phone:614-806-6816
Mailing Address - Fax:
Practice Address - Street 1:5498 PONDEROSA DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-3134
Practice Address - Country:US
Practice Address - Phone:614-806-6816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 123006164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse