Organization
PRACTITIONERS WITHOUT WALLS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FUNMI OLUKOYA APRN, FNP (CEO)
(832) 633-3186
Entity
Organization
Contact information
Practice address
15333 N PIMA RD STE 305, SCOTTSDALE, AZ 85260-2717
(832) 633-3186
Mailing address
21802 SILVERPEAK CT, KATY, TX 77450-5622
(832) 633-3186
Taxonomy
Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QM1000X
Migrant Health Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629307202
NPI
TX
Enumeration date
05/30/2021
Last updated
01/04/2025
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