Individual
MRS. OLUYINKA GRACE OSUNNUGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(765) 674-3321
Mailing address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(765) 674-3321
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
28144611A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71004923A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201230310
—
IN
Enumeration date
05/12/2014
Last updated
08/25/2021
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