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Individual

ABIOLA AWENI BABALOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1001 S GEORGE ST, 3RD FLOOR, YORK, PA 17403-3676
(717) 851-4005
(717) 812-2495
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-4005
(717) 812-2495

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP012629
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1619013
GATEWAY MEDICARE ASSURED
PA
01
2862260
HIGHMARK BLUE SHIELD - FREEDOM BLUE
PA
Enumeration date
01/09/2013
Last updated
06/10/2016
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