Individual
OBAFEMI AKINSANYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4646 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6842
(484) 541-3678
Mailing address
4646 W JEFFERSON BLVD STE 100, FORT WAYNE, IN 46804-6832
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28222440C
IN
Other
Enumeration date
03/24/2023
Last updated
03/29/2023
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