Basic Information
| Provider Information | |||||||||
| NPI: | 1801174974 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOKWAULU | ||||||||
| FirstName: | FANYA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ARNP FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5975 SUNSET DR | ||||||||
| Address2: | SUITE 402 | ||||||||
| City: | SOUTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331435166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056692834 | ||||||||
| FaxNumber: | 3056692840 | ||||||||
| Practice Location | |||||||||
| Address1: | 5975 SUNSET DR | ||||||||
| Address2: | SUITE 402 | ||||||||
| City: | SOUTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331435166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056692833 | ||||||||
| FaxNumber: | 3056692840 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2011 | ||||||||
| LastUpdateDate: | 03/08/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN 9269319 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.