Individual
FUNMILAYO RITA FASHOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1380 SOUTHERN AVE SE, WASHINGTON, DC 20032-4623
(202) 279-5580
Mailing address
5324 THOMAS SIM LEE TER, UPPER MARLBORO, MD 20772-7422
(301) 433-5538
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
R197537
MD
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN1025198
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2021085548
ANCC
—
Enumeration date
11/15/2021
Last updated
11/15/2021
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