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General NPI Number Information
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NPI Number | 1356010987
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Entity Type | Individual
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Provider Name | FUNGISAI JULIET MARUMAHOKO BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 1500 E GUDE DR
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City | ROCKVILLE
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State | MD
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Zip | 20850-5307
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Country | US
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Telephone | 240-777-1684
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Fax |
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Provider Business Mailing Address
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Address Line | 5011 JEFFREY DR
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City | MOUNT AIRY
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State | MD
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Zip | 21771-8927
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Country | US
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Telephone | 301-461-4814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R204436
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License Number State | MD
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