Provider Demographics
NPI:1891492302
Name:ATABONG, FONYA (DNP RN)
Entity Type:Individual
Prefix:DR
First Name:FONYA
Middle Name:
Last Name:ATABONG
Suffix:
Gender:F
Credentials:DNP RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15000 POTOMAC TOWN PL STE 100-147
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6586
Mailing Address - Country:US
Mailing Address - Phone:571-762-0189
Mailing Address - Fax:
Practice Address - Street 1:15000 POTOMAC TOWN PL STE 100-147
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-6586
Practice Address - Country:US
Practice Address - Phone:571-762-0189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-14
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care