Individual
DAVID OLATUNBOSUN FOWOPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
7830 JOHNSON RD, INDIANAPOLIS, IN 46250-2075
(317) 396-0683
Mailing address
7830 JOHNSON RD, INDIANAPOLIS, IN 46250-2075
(317) 396-0683
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71016847A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300065740
—
IN
Enumeration date
07/17/2025
Last updated
01/12/2026
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