Individual
DR. FAUSAT FUNMILOLA ODUBIYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1221 N CHURCH ST STE 103-E, MOORESTOWN, NJ 08057-1245
(609) 471-3560
(833) 520-1488
Mailing address
1221 N CHURCH ST STE 103-E, MOORESTOWN, NJ 08057-1245
(609) 471-3560
(833) 520-1488
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
26NR22474600
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402510
NY
Other
Enumeration date
08/21/2018
Last updated
09/23/2024
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