Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 100846 | OK |
NPI | 1003397332 |
---|---|
Provider Name | Adekemi Taiwo |
First Address | Tulsa, OK 74133 |
Second Address | Tulsa, OK 74133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2018 |
Last Update Date | 24/08/2018 |