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Individual

MR. OLULEKE ANTHONY OLAIYA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
2005 W ELM ST, ROGERS, AR 72758-4018
(479) 427-7722
(479) 427-7721
Mailing address
3600 S NATIONAL AVE, SPRINGFIELD, MO 65807-7311
(417) 322-6622
(417) 350-1935

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
223594
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
297625758
AR
Enumeration date
07/06/2022
Last updated
06/15/2023
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