Individual
BOLANLE TINUKE AMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FCNP
Contact information
Practice address
725 WICKER AVE, SUITE 202, BENSALEM, PA 19020-7251
(215) 639-4646
(215) 639-2323
Mailing address
725 WICKER AVE, SUITE 202, BENSALEM, PA 19020-7251
(215) 639-4646
(215) 639-2323
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR11110200
NJ
163W00000X
Registered Nurse
568664
PA
363LF0000X
Family Nurse Practitioner
Primary
SP012757
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017673
PRESCRIPTIVE AUTHORITY (BUREAU OF PROFESSIONAL & OCCUPATIONAL AFFAIRS)
PA
01
—
568664
REGISTERED NURSE
PA
01
—
SP012757
PA CERTIFIED REGISTERED NURSE PRACTIONER (FAMILY HEALTH)
PA
Enumeration date
05/03/2013
Last updated
05/03/2013
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