Organization
BLISSFUL MINDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMOTOLU OLAITAN AJE-OMOKORE DNP (PROVIDER)
(316) 990-4126
Entity
Organization
Contact information
Practice address
10401 MONTGOMERY PKWY NE STE 1A, ALBUQUERQUE, NM 87111-3876
(505) 595-2680
Mailing address
10401 MONTGOMERY PKWY NE STE 1A, ALBUQUERQUE, NM 87111-3876
(505) 595-2680
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548699739
—
KS
05
—
1841624855
—
TX
Enumeration date
07/21/2022
Last updated
07/23/2022
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