Provider Demographics
NPI:1073111233
Name:BANGURA, CATHERINE DENISE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DENISE
Last Name:BANGURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PEPPER MILL DR
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-2743
Mailing Address - Country:US
Mailing Address - Phone:202-823-6107
Mailing Address - Fax:
Practice Address - Street 1:3348 BLAINE ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1327
Practice Address - Country:US
Practice Address - Phone:202-399-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide