Individual
YVONNE FONGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6420 AUTUMN GOLD CT, COLUMBIA, MD 21045-5419
(404) 512-0791
Mailing address
6420 AUTUMN GOLD CT, COLUMBIA, MD 21045-5419
(404) 512-0791
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R207998
MD
163W00000X
Registered Nurse
Primary
RN1031761
DC
Other
Enumeration date
01/09/2014
Last updated
01/09/2014
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