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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACKSON NJI FONLON TANIFORM NGWA

Active Sole Proprietor

JACKSON NJI FONLON TANIFORM NGWA is a Community Health Worker healthcare provider located in CAPITOL HEIGHTS, Maryland. NPI 1467264515 is currently active in the NPPES registry. Verify at CMS.

Community Health Worker · CAPITOL HEIGHTS, MD

Registration Details

NPI Number
1467264515
Provider Type
Individual
Gender
Male
NPI Issued
Jan 24, 2025 (1.5486379246541 yrs)
Last Updated
Jan 27, 2025
Sole Proprietor
Yes

Practice Information

Address
5221 CAPITOL HEIGHTS
CAPITOL HEIGHTS, MD, 20743
Browse MD providers · Browse ZIP 20743
Phone
9134942143
Primary Specialty
Community Health Worker
172V00000X
Additional Specialty
Community Health Worker

Other Community Health Worker Providers in CAPITOL HEIGHTS, MD

Name Credential NPI
KAYODE OGUNBODE 1043572183
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.