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Organization

FO NURSE PRACTITIONER IN PSYCHIATRY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FADEKEMI SULIAT OLUDE (CEO)
(972) 449-7614
Entity
Organization

Contact information

Practice address
246-09 139TH AVENUE, ROSEDALE, NY 11422
(972) 449-7614
(972) 947-5275
Mailing address
3449 AVA DR, MIDLOTHIAN, TX 76065-2274
(972) 449-7614
(972) 947-5275

Taxonomy

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

Other

Enumeration date
08/13/2024
Last updated
08/14/2024
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