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

Maxine Fomunung

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1225802168

Maxine Fomunung is a Psychiatric/Mental Health Nurse Practitioner in Woodstock, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2023

Practice location Address checks out

409 Old Boring Ln
Woodstock, GA 30189-2495
Phone: (470) 461-3426
Fax: (770) 928-7558
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 RN291792 (GA)

Record details

NPI number1225802168
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 10, 2023
Last updated in NPPESMarch 18, 2025
Certification dateMarch 18, 2025

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