MEDICARE: FNU ISABELLE FOMUKONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1942131339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FNU ISABELLE FOMUKONG

Provider Business Mailing Address
First Line	:	1012 OVERLOOK WAY
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20707-6404
Country	:	US
Telephone Number	:	470-997-7373
Fax Number	:

Provider Business Practice Location Address
First Line	:	1012 OVERLOOK WAY
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20707-6404
Country	:	US
Telephone Number	:	470-997-7373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

Similar Medicare Providers

1144701970 — LAUREN ANNICK PETTYJOHN-ROBIN
Practice Location Address:

6404 ORLY LN
LAUREL, MD
20707-2980

Practice Phone: 301-875-7154
Practice Fax:

1205561321 — D&D COMPASSIONATE CARE
Practice Location Address:

6404 PARK HALL DRIVE WEST
LAUREL, MD
20707-2070

Practice Phone: 301-412-0306
Practice Fax:

1104330604 — VERNETT L KING-CAGE
Practice Location Address:

6869 LAUREL HILL AVE
BAKER, LA
70714-6404

Practice Phone: 225-278-1584
Practice Fax:

1841158557 — UNITED SUPPORT HEALTHCARE, LLC.
Practice Location Address:

935 PARK HILL RD
LAUREL, MD
20707-3433

Practice Phone: 301-265-6625
Practice Fax:

1780515304 — CHARM CITY SPEECH, LLC
Practice Location Address:

13994 BALTIMORE AVE STE 101
LAUREL, MD
20707-5174

Practice Phone: 443-718-0563
Practice Fax:

1245124387 — JANESE MATOS
Practice Location Address:

14440 CHERRY LANE CT STE 208
LAUREL, MD
20707-4946

Practice Phone: 301-604-1458
Practice Fax:

Directions to “ FNU ISABELLE FOMUKONG ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.