Individual
FATUMATA FOFANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16 FAIRHAVEN RD, WORCESTER, MA 01606-3114
(508) 410-8907
Mailing address
16 FAIRHAVEN RD, WORCESTER, MA 01606-3114
(508) 410-8907
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2382717
MA
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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