# MR. SAMUEL OLAOLUWA OMOLADE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1548799141
- **Gender:** Man
- **Credential:** APRN PMHNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WA2000X | Administrator Registered Nurse | 958104 | TX | — |
| 164W00000X | Licensed Practical Nurse | 320878-1 | NY | — |
| 171M00000X | Case Manager/Care Coordinator | 958104 | TX | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 1099855 | TX | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AP61366158 | WA | — |

## Other

- **Enumeration date:** 06/07/2017
- **Last updated:** 07/15/2023