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Individual

BASIRAT OLADUNNI SHOMUYIWA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11340 LAKEFIELD DR STE 200, JOHNS CREEK, GA 30097-2456
(678) 895-8405
Mailing address
1115 HERRINGTON RD, LAWRENCEVILLE, GA 30044-7503
(678) 895-8405

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN136389
GA

Other

Enumeration date
10/01/2024
Last updated
08/20/2025
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