Provider Demographics
NPI:1174810287
Name:BOGUNJOKO, COMFORT DUPE (RN BSN, MSC)
Entity type:Individual
Prefix:MRS
First Name:COMFORT
Middle Name:DUPE
Last Name:BOGUNJOKO
Suffix:
Gender:F
Credentials:RN BSN, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12217 KINGS ARROW ST
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1943
Mailing Address - Country:US
Mailing Address - Phone:240-354-1632
Mailing Address - Fax:240-245-3910
Practice Address - Street 1:3115 GEORGIA AVE NW
Practice Address - Street 2:SUITE 3
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2901
Practice Address - Country:US
Practice Address - Phone:202-829-1595
Practice Address - Fax:202-829-1812
Is Sole Proprietor?:No
Enumeration Date:2011-07-09
Last Update Date:2011-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1003995163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management