Provider Demographics
NPI:1588045256
Name:FOKWA, MANKAA HELEN (FNP)
Entity Type:Individual
Prefix:
First Name:MANKAA
Middle Name:HELEN
Last Name:FOKWA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42542 CINNABAR CT
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-4406
Mailing Address - Country:US
Mailing Address - Phone:323-327-6713
Mailing Address - Fax:
Practice Address - Street 1:540 W PALMDALE BLVD # B
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4232
Practice Address - Country:US
Practice Address - Phone:661-947-5600
Practice Address - Fax:661-947-5900
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily