Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 26NJ00474200 | NJ |
N | 363LP2300X | Nurse Practitioner - Primary Care | 2012020891 | NJ |
N | 363LP2300X | Nurse Practitioner - Primary Care | 26NJ00474200 | NJ |
NPI | 1043646839 |
---|---|
Provider Name | Mrs. Christianah O Adelakun |
First Address | Vauxhall, NJ 07088-1334 |
Second Address | Vauxhall, NJ 07088-1334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2013 |
Last Update Date | 03/01/2022 |