Olufunso K Fakunle

Individual provider Active NPI Home Health Aide · Forestville, MD

NPI 1114277183 · NPPES record last updated Sep 17, 2012

Key facts

NPI
1114277183
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Aide 374U00000X
Practice address
8409 Laura LN
Forestville, MD 20747-2586
Phone
(202) 635-6006
NPI assigned
Sep 17, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Yes

Addresses

Primary practice location

8409 Laura LN
Forestville, MD 20747-2586

Mailing address

8409 Laura LN
Forestville, MD 20747-2586
Phone (202) 635-6006

Other providers in Forestville, MD

All providers in Forestville, MD · Home Health Aide in Maryland

Sources for this page

Verify at the official NPI Registry.