Individual
LOLADE OGUNLEYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
16165 N 83RD AVE STE 200, PEORIA, AZ 85382-5816
(919) 307-2114
Mailing address
16165 N 83RD AVE STE 200, PEORIA, AZ 85382-5816
(919) 307-2114
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
239003
NC
2084P0800X
Psychiatry Physician
250524
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
250524
AZ
Other
Enumeration date
08/20/2020
Last updated
12/01/2020
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