Individual
MAGUIEM TAKO FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1615 KENILWORTH AVE NE, WASHINGTON, DC 20019-2010
(202) 588-8036
Mailing address
9741 GOOD LUCK RD APT 11, LANHAM, MD 20706-3320
(240) 590-4177
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP56302
MD
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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