MEDICARE: MS. ADEOLA ABIDEMI BABARINDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	NP288930	GA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NP288930	GA

General Provider Information

NPI Number	:	1790062420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ADEOLA ABIDEMI BABARINDE

Provider Business Mailing Address
First Line	:	2483 POWDER SPRINGS RD SW STE 110
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-4573
Country	:	US
Telephone Number	:	770-771-8095
Fax Number	:

Provider Business Practice Location Address
First Line	:	2483 POWDER SPRINGS RD SW STE 110
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-4573
Country	:	US
Telephone Number	:	770-771-8095
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2011
Last Update Date	:	03/12/2026

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