Individual
MARY TOKUNBO FAGBOHUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
512 OLD POTOMAC CHURCH RD, STAFFORD, VA 22554-7380
(510) 585-6551
Mailing address
2433 SAN MARCO LN, EDMOND, OK 73034-2354
(510) 585-6551
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0087816
OK
Other
Enumeration date
12/20/2024
Last updated
12/20/2024
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