WILSON CHICK FANSO FOMUKOM
NPI 1912719717
Home Health Aide in Bowie, MD
Active since January 21, 2025
About Wilson Chick Fanso Fomukom NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILSON CHICK FANSO FOMUKOM (NPI 1912719717) is an individual home health aide in Bowie, Maryland and active in the NPI registry since January 2025.
NPPES Registry Identity
NPI1912719717
Entity TypeIndividualMale
Primary Taxonomy374U00000X
Provider Legal NameWILSON CHICK FANSO FOMUKOM
Location Address6421 GWINNETT LNBowie, MD 20720-5320
Mailing Address6421 Gwinnett LnBowie, MD 20720-5320 · (202) 604-4262
Phone(202) 604-4262
Sole ProprietorNo
Enumeration DateJanuary 21, 2025
NPPES CertifiedJanuary 21, 2025
✔ NPI 1912719717 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyHome Health AideNursing Service Related Providers
Taxonomy Code374U00000X
Definition
A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes.
6421 GWINNETT LN, Bowie, MD 20720
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912719717, enumerated as an "individual" on January 21, 2025.
The provider is located at 6421 GWINNETT LN BOWIE, MD 20720 and the phone number is (202) 604-4262.
Home Health Aide with taxonomy code 374U00000X.
