Individual
VIVIAN ANGYIAHEN FOMUKONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9276 ADELPHI RD APT 204, HYATTSVILLE, MD 20783-2029
(202) 378-6632
Mailing address
9276 ADELPHI RD APT 204, HYATTSVILLE, MD 20783-2029
(202) 378-6632
Taxonomy
Speciality
Code
Description
License number
State
364SH0200X
Home Health Clinical Nurse Specialist
Primary
HHA8384
DC
Other
Enumeration date
06/23/2013
Last updated
06/23/2013
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