Individual
OLUWASEYI LADIPUPO SOETAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP - BC
Contact information
Practice address
26317 WASHINGTON ST, NORTH DINWIDDIE, VA 23803-2727
(540) 204-2459
Mailing address
5706 GOSSAMER CT, MOSELEY, VA 23120-2339
(540) 204-2459
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024180400
VA
Other
Enumeration date
11/14/2020
Last updated
04/30/2024
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