Individual
BOLANLE AWOTIKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11747 GIOVANNI LN, RICHMOND, TX 77406-1536
(630) 504-8745
Mailing address
11747 GIOVANNI LN, RICHMOND, TX 77406-1536
(630) 504-8745
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
950536
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1124240
TX
Other
Enumeration date
09/18/2018
Last updated
01/22/2024
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