Provider Demographics
NPI:1699572693
Name:BANGURA, ANNET ISATA
Entity type:Individual
Prefix:
First Name:ANNET
Middle Name:ISATA
Last Name:BANGURA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4972 BLACK SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4501
Mailing Address - Country:US
Mailing Address - Phone:614-377-0911
Mailing Address - Fax:
Practice Address - Street 1:4972 BLACK SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4501
Practice Address - Country:US
Practice Address - Phone:614-377-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health