Healthcare Provider Details

I. General information

NPI: 1992668826
Provider Name (Legal Business Name): OLAJUMOKE OGUNBAYO APRN AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 TURNPIKE ST
NORTH ANDOVER MA
01845-6322
US

IV. Provider business mailing address

1801 TURNPIKE ST
NORTH ANDOVER MA
01845-6322
US

V. Phone/Fax

Practice location:
  • Phone: 603-264-5440
  • Fax:
Mailing address:
  • Phone: 603-264-5440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN2379348
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number087223-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: