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Organization
LIFE SPAN WELLNESS LLC
Active
Organization
LIFE SPAN WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABIODUN AKINOLA OLATUBOSUN (APN)
(862) 220-6803
Entity
Organization
Contact information
Practice address
156 BALDWIN PL, BLOOMFIELD, NJ 07003-6036
(862) 220-0914
(862) 306-1037
Mailing address
156 BALDWIN PL, BLOOMFIELD, NJ 07003-6036
(862) 220-0914
(862) 306-1037
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/05/2023
Last updated
08/26/2026
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