Individual
ABIMBOLA OLUFUNKE FAGUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1740 W EVERMAN PKWY, FORT WORTH, TX 76134
(732) 882-2418
Mailing address
1740 W EVERMAN PKWY, FORT WORTH, TX 76134
(732) 882-2418
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
26NR12599800
NJ
163WH0200X
Home Health Registered Nurse
26NR12599800
NJ
163WS0200X
School Registered Nurse
26NR12599800
NJ
311ZA0620X
Adult Care Home Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
TX
Other
Enumeration date
07/01/2025
Last updated
07/21/2025
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