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MRS. YEWANDE TEMITOPE MIKOKU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
27 DIXON AVE, STATEN ISLAND, NY 10302-1938
(917) 841-6757
Mailing address
27 DIXON AVE, STATEN ISLAND, NY 10302-1938
(917) 841-6757

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
559805-1
NY
363L00000X
Nurse Practitioner
Primary
403469
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
403469
NY

Other

Enumeration date
05/08/2007
Last updated
11/25/2022
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