Provider Demographics
NPI:1447049119
Name:KARGBO, FEREMUSU
Entity type:Individual
Prefix:
First Name:FEREMUSU
Middle Name:
Last Name:KARGBO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:FEREMUSU
Other - Middle Name:
Other - Last Name:BANGURA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8206 STUDENT DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2177
Mailing Address - Country:US
Mailing Address - Phone:240-280-4193
Mailing Address - Fax:
Practice Address - Street 1:2811 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-3865
Practice Address - Country:US
Practice Address - Phone:202-894-6811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN500021733163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse