MAXINE FOMUNUNG

WOODSTOCK, GA
NPI1225802168
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: GA  RN291792)
Enumeration Date2023-11-10
Last Update Date2025-03-18
Business Address
MAXINE FOMUNUNG
409 OLD BORING LN
WOODSTOCK, GA 30189-2495
Phone number: 470-461-3426
Mailing Address
MAXINE FOMUNUNG
3206 THIMBLEBERRY TRL
DACULA, GA 30019-7299
Phone number: 470-461-3426
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