Individual
MANINGBE FOFANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12703 COURAGE XING, FISHERS, IN 46037-5963
(317) 789-6127
Mailing address
12703 COURAGE XING, FISHERS, IN 46037-5963
(317) 789-6127
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28256972A
IN
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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