Healthcare Provider Details

I. General information

NPI: 1790358976
Provider Name (Legal Business Name): OLUWABUNMI M BAMIDELE RN, APRN, FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 CUMBERLAND BND
NASHVILLE TN
37228-1805
US

IV. Provider business mailing address

1615 SHENSTONE DR
SMYRNA TN
37167-3598
US

V. Phone/Fax

Practice location:
  • Phone: 615-782-6201
  • Fax:
Mailing address:
  • Phone: 323-337-3122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN0000195960
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07202380
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2024028636
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN0000028533
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: