Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Khadija Fofana

Individual provider Intellectual & Developmental Disabilities Psychologist · NPI 1407413297

Khadija Fofana is a Nurse Practitioner in Somerset, New Jersey. Qualified in 2020, 6 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
6
Licensed in
NJ
In the registry since
2019
Specialties on file
2

Practice location Address checks out

122 Girard Ave
Somerset, NJ 08873-2417
Phone: (717) 341-8790
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 26NJ01045000 (NJ)
Intellectual & Developmental Disabilities Psychologist Taxonomy 103TM1800X

Record details

NPI number1407413297
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 28, 2019
Last updated in NPPESNovember 7, 2022
Certification dateNovember 7, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare