Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2020004352 | NC |
NPI | 1003439639 |
---|---|
Provider Name | Mrs. Olufunso Mercy Ogunjobi |
First Address | Greensboro, NC 27407-6127 |
Second Address | Greensboro, NC 27407-6127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2020 |
Last Update Date | 18/05/2020 |