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Individual

AUGUSTINA FAKIYESI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2401 W CHELTENHAM AVE, WYNCOTE, PA 19095-2946
(215) 444-7471
Mailing address
PO BOX 746722, ATLANTA, GA 30374-6722
(312) 733-9730

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP015662
PA

Other

Enumeration date
01/11/2016
Last updated
04/28/2025
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