Individual
OLUBUKOLA KOMOLAFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
13838 S 46TH PL STE 340, PHOENIX, AZ 85044-7805
(832) 542-3181
Mailing address
PO BOX 2251, SCOTTSDALE, AZ 85252-2251
(832) 542-3181
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP10975
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP10975
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
451416
—
AZ
Enumeration date
02/08/2018
Last updated
10/01/2021
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