Euphrasie Diane Fomekong

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

26NR23175500 Issued in NJ

Practice address

119 Mountainview Rd
Mount Laurel, NJ 08054-4730

Phone

(862) 899-6367

NPI assigned

Feb 2, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1942063888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 MOUNTAINVIEW RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544730",
            "telephone_number": "862-899-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 MOUNTAINVIEW RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080544730",
            "telephone_number": "862-899-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMEKONG",
        "first_name": "EUPHRASIE",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NJ",
            "license": "26NR23175500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Elizabeth Fitzgerald, CRNA
• Theresa Ann Fitzgerald, LCSW
• Brooke Lauren Fletcher
• Randa Baher Foda, M.D.
• Kate Foley
• Julia Marie Ford, MS, OTR/L
• Lareece Ford
• Nicholas Forvour, BCBA
• Barbara Ellen Fox, PH.D.
• Paulette Fredericks, MSW, LCSW

• General Practice Registered Nurse in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• General Practice Registered Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.