Individual
MASERAY FOFANAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1717 W NORTHERN AVE STE 211, PHOENIX, AZ 85021-5469
(480) 249-2655
Mailing address
257 N STATE RD APT 25A, SPRINGFIELD, PA 19064-1826
(161) 076-6149
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1068830
TX
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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