MAFON FOMUJANG (NPI# 1013442102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013442102 |
| Entity Type | Individual |
| Full Name | MAFON FOMUJANG |
| Credential | NURSE PRACTITIONER |
| Practice Address |
13422 Kinsman Rd Cleveland OH 44120-4410 |
| Mailing Address |
10 Salt Creek Run Peninsula OH 44264-9461 |
| Practice Telephone | 8665366038 |
| Mailing Telephone | 4055496290 |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2019-07-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN.404876 | OH | Nursing Service Providers |
| Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
023666 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12395 Mccracken Rd Ste A, Garfield Heights, OH 441252946 | 2165876727 | |
| 1930 Fulton Rd Nw # 103, Canton, OH 447093526 | 3309565936 | 3309565623 |
| Street Address |
13422 KINSMAN RD |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44120-4410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629001920 | Murtis Taylor Human Services System | Clinic/Center | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2006-07-09 |
| 1154938306 | Danielle Wolf | Case Manager/Care Coordinator | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2020-09-30 |
| 1447867015 | Shakeela Rogers | Case Manager/Care Coordinator | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2020-09-28 |
| 1649887217 | Tyra S. Anthony | Case Manager/Care Coordinator | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2020-09-28 |
| 1407463482 | Carson V. Traylor | Case Manager/Care Coordinator | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2020-09-24 |
| 1346857315 | Bre-anna Carruthers | Case Manager/Care Coordinator | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2020-09-24 |
| 1023625084 | Belinda Susan Bailey | Social Worker | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2020-09-24 |
| 1528674165 | Andrea Wingfield | Social Worker | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2020-09-18 |
| 1306452305 | Jean Marc Sims | Case Manager/Care Coordinator | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2020-09-16 |
| 1982238762 | Sharita L.c. Hicks | Case Manager/Care Coordinator | 13422 Kinsman Rd, Cleveland, OH 44120-4410 | 2020-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578275 | Steps To Wellness, Inc. | Counselor | 3577 East 144h Street, Cleveland, OH 44120 | 2020-11-02 |
| 1396343752 | Chauncey Lang | Homemaker | 3090 #10 Livingston Ave, Cleveland, OH 44120 | 2020-10-16 |
| 1558999607 | Delores Collins | Community Health Worker | 12200 Farhill Rd C-349, Cleveland, OH 44120 | 2020-04-01 |
| 1497396949 | Renisha Delia Spencer | Home Health | 3387 E. 137th Street, Cleveland, OH 44120 | 2019-10-07 |
| 1598313249 | Torrence Hands Healthcare LLC | Clinic/Center | 3440 Avalon Road Apt 204, Shaker Hts, OH 44120 | 2019-08-27 |
| 1164908067 | Complete Recovery LLC | Clinic/Center | 2618 N Moreland Blvd, Cleveland, OH 44120 | 2018-07-13 |
| 1871095000 | Stacy-ann Camile Durrant | Nurse's Aide | 13800 Fairhill Rd, 115, Shaker Heights, OH 44120 | 2018-03-03 |
| 1144749904 | Alliant Health Services | Clinic/Center | 3535 Lee Road, Shaker Heights, OH 44120 | 2017-09-13 |
| 1972025864 | Eugene Platts Jr. | Counselor | 12024 Shaker Blvd # 502, Cleveland, OH 44120 | 2017-07-12 |
| 1942739438 | Aaliyah Fields | Nurse Practitioner | 3070 Becket Rd, Cleveland, OH 44120 | 2017-06-08 |
| Find all providers in zip 44120 | ||||
| Taxonomy Code | 364SP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235503954 | Alison R Henton | Clinical Nurse Specialist | 18697 Bagley Rd, Cleveland, OH 44130-3417 | 2015-11-18 |
| 1346507266 | Fairfax Medical Facilities Inc | Clinical Nurse Specialist | 100 N Hickerson Dr, Cleveland, OK 74020-4003 | 2012-04-17 |
| 1902037500 | Paula Malbon | Clinical Nurse Specialist | 2500 Metrohealth Dr, Cleveland, OH 44109-1900 | 2009-07-30 |
| 1114041779 | Maureen Louise Curley | Clinical Nurse Specialist | 11100 Euclid Ave, Cleveland, OH 44106-1716 | 2007-03-19 |
| 1164588174 | Michele A Bender | Clinical Nurse Specialist | 2500 Metrohealth Dr, Mhmc-psychiatry, Cleveland, OH 44109-1900 | 2006-12-28 |
| 1952326258 | Rose Anne Berila | Clinical Nurse Specialist | 11100 Euclid Ave, Cleveland, OH 44106-1716 | 2006-07-13 |
| 1861424863 | William A Zrenner | Clinical Nurse Specialist | 6835 Broadway Ave, Metrohealth Broadway Health Center, Cleveland, OH 44105-1313 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632082 | Davi Ann Hardy | Clinical Nurse Specialist | 6408 Stoll Ln, Cincinnati, OH 45236-4033 | 2020-02-27 |
| 1336693530 | Robert Conkel | Clinical Nurse Specialist | 534 River Pebble Dr, Blacklick, OH 43004-9233 | 2016-08-05 |
| 1265891907 | Michele R. Cash, LLC | Clinical Nurse Specialist | 899 E Broad St Fl 4, Columbus, OH 43205-1156 | 2016-02-22 |
| 1487840120 | Jane M Root | Clinical Nurse Specialist | 104 Javit Court, Austintown, OH 44515-3117 | 2007-09-17 |
| 1891855482 | Jeffrey Schwab Jones | Clinical Nurse Specialist | 524 Townview Cir E, Mansfield, OH 44907-1134 | 2006-12-12 |
| 1508963216 | Sharon Lynn Dragovich | Clinical Nurse Specialist | 12616 Sharon Lynn Dr, Salem, OH 44460-9134 | 2006-09-17 |
| 1407890908 | Linda L Bertsche | Clinical Nurse Specialist | 2434 Richmiller Ln Unit F, Belpre, OH 45714-1075 | 2006-06-15 |
| 1851339444 | Margaret D Ashenberg | Clinical Nurse Specialist | 6449 Wilson Mills Rd, Mayfield Village, OH 44143-3438 | 2006-06-03 |
| 1528059466 | Andrea J Bedway | Clinical Nurse Specialist | 1305 Olentangy River Rd, Columbus, OH 43212-3120 | 2005-10-31 |
| 1083605950 | Bonita C Beardslee | Clinical Nurse Specialist | 5025 Arlington Centre Blvd, Suite 500, Columbus, OH 43220-2959 | 2005-10-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.