Healthcare Provider Details

I. General information

NPI: 1578493565
Provider Name (Legal Business Name): OLUWADAMILOLA M AKERELE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11345 TARA BLD P O B0X 177
HAMPTON GA
30228
US

IV. Provider business mailing address

11345 TARA BLD P O B0X 177
HAMPTON GA
30228
US

V. Phone/Fax

Practice location:
  • Phone: 678-270-7421
  • Fax:
Mailing address:
  • Phone: 678-270-7421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN290785
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: