Provider Demographics
NPI:1750913380
Name:FUONDJING, NICOLE NJIJEN I (NP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:NJIJEN
Last Name:FUONDJING
Suffix:I
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:NICOLE
Other - Middle Name:NJIJEN
Other - Last Name:NWAFOR
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3549 TRIBECA TRL
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-1445
Mailing Address - Country:US
Mailing Address - Phone:240-643-8300
Mailing Address - Fax:
Practice Address - Street 1:15245 SHADY GROVE RD STE 130
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6240
Practice Address - Country:US
Practice Address - Phone:240-643-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR216392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily