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Individual

OBIANUJU OKPALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
250 NORTH AVE, ATHENS, GA 30601-2244
(706) 389-6789
Mailing address
1404 RICHMOND OAK CT, LOGANVILLE, GA 30052-9078

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2019046362
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN211902
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN211902
NURSING LICENSE
GA
Enumeration date
04/22/2020
Last updated
08/15/2023
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