Individual
OLUBUKOLA OLOTU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1784 BROOKSTONE CT NW, ACWORTH, GA 30101-4562
(872) 212-7240
Mailing address
1784 BROOKSTONE CT NW, ACWORTH, GA 30101-4562
(872) 212-7240
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9627720
FL
164W00000X
Licensed Practical Nurse
043.131119
IL
164W00000X
Licensed Practical Nurse
LPN100801
GA
Other
Enumeration date
03/15/2023
Last updated
05/02/2023
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