Provider Demographics
NPI:1194006791
Name:TUNKARA, MANSURA
Entity Type:Individual
Prefix:MS
First Name:MANSURA
Middle Name:
Last Name:TUNKARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:
Other - Last Name:AGHAYERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:STNA
Mailing Address - Street 1:5653 EARNINGS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-7431
Mailing Address - Country:US
Mailing Address - Phone:646-305-3122
Mailing Address - Fax:
Practice Address - Street 1:5653 EARNINGS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-7431
Practice Address - Country:US
Practice Address - Phone:646-305-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400596970307374U00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker