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Individual

OLUBANKE BABALOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
17979 NE GLISAN ST, PORTLAND, OR 97230-6507
(888) 227-3312
Mailing address
PO BOX 3229, PORTLAND, OR 97208-3229

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201605458NP-PP
OR
363LF0000X
Family Nurse Practitioner
AP125699
TX
363LF0000X
Family Nurse Practitioner
AP61009656
WA
363LF0000X
Family Nurse Practitioner
NUR-APRN-LIC-157784
MT

Other

Enumeration date
05/23/2014
Last updated
10/02/2020
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