Provider Demographics
NPI:1326272899
Name:MANSARAY, AMINATA (AANPB-NP-C , RN-BSN)
Entity Type:Individual
Prefix:MS
First Name:AMINATA
Middle Name:
Last Name:MANSARAY
Suffix:
Gender:F
Credentials:AANPB-NP-C , RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1792 BRANDIGEN LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-3881
Mailing Address - Country:US
Mailing Address - Phone:614-353-3697
Mailing Address - Fax:
Practice Address - Street 1:3886 BROADWAY STE B
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2207
Practice Address - Country:US
Practice Address - Phone:614-274-9092
Practice Address - Fax:614-547-0880
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH339001163W00000X
OHF05210642363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse