Individual
BOLAJI KEHINDE ADETIBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN-ANP
Contact information
Practice address
9 MEDICAL PKWY, STE 308, DALLAS, TX 75234-7858
(972) 888-7240
(972) 888-7285
Mailing address
PO BOX 2932, YUMA, AZ 85366-2401
(928) 276-4477
(928) 276-4481
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
731957
TX
Other
Enumeration date
01/18/2013
Last updated
12/06/2017
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