Individual
FESE E BOKOSAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2671 RICKER POND CT, WALDORF, MD 20603-2060
(240) 463-6359
Mailing address
2671 RICKER POND CT, WALDORF, MD 20603
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1032974
DC
363LG0600X
Gerontology Nurse Practitioner
R205199
MD
363LG0600X
Gerontology Nurse Practitioner
RN1032974
DC
Other
Enumeration date
09/11/2020
Last updated
06/23/2025
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