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Organization
FO NURSE PRACTITIONER IN PSYCHIATRY PLLC
Active
Organization
FO NURSE PRACTITIONER IN PSYCHIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FADEKEMI SULIAT OLUDE (CEO)
(972) 449-7614
Entity
Organization
Contact information
Practice address
246-09 139TH AVENUE, ROSEDALE, NY 11422
(972) 449-7614
(972) 947-5275
Mailing address
3449 AVA DR, MIDLOTHIAN, TX 76065-2274
(972) 449-7614
(972) 947-5275
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
08/13/2024
Last updated
08/14/2024
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