Individual
MRS. OLUBUNMI TINA AYENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2759 MOUNT ZION PKWY, JONESBORO, GA 30236-2568
(678) 289-8338
(770) 603-0515
Mailing address
2759 MOUNT ZION PKWY, JONESBORO, GA 30236-2568
(678) 289-8338
(770) 603-0515
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN174210
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN174210
ADVANCED PRACTICE LICENSE
GA
Enumeration date
06/23/2020
Last updated
06/23/2020
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