Individual
MRS. MARY RUTH FOFANAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NA
Contact information
Practice address
509 RIVERS EDGE DR, FREDERICKSBURG, VA 22405-1298
(571) 501-5981
(571) 501-5981
Mailing address
509 RIVERS EDGE DR, FREDERICKSBURG, VA 22405-1298
(571) 501-5981
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
1401103712
VA
Other
Enumeration date
11/24/2025
Last updated
11/24/2025
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