Individual provider · Type 1 NPI
Fatmata Fofanah, PMHNP
Nurse Practitioner · Raleigh, NC
Practice location
4320 Bland Rd Ste 104
Raleigh, NC 27609-6125
Mailing address
4608 Jersey Pine Dr
Rolesville, NC 27571-8746
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 2025047788 (NC) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1780546705
Fatmata Fofanah, PMHNP's National Provider Identifier is 1780546705, issued on Nov 28, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Raleigh, NC. The record was last updated on Nov 28, 2025.