Individual
OMOTADE ADEMOYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(918) 579-1000
Mailing address
18713 E 42ND PL, TULSA, OK 74134-5927
(918) 924-1781
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
210459
OK
Other
Enumeration date
11/18/2022
Last updated
11/18/2022
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