Healthcare Provider Details

I. General information

NPI: 1689042244
Provider Name (Legal Business Name): ADEJOKE ADETOUN AWOLEYE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 W PLEASANT RIDGE RD
ARLINGTON TX
76016-4427
US

IV. Provider business mailing address

1545 ATLANTIC AVE
BROOKLYN NY
11213-1122
US

V. Phone/Fax

Practice location:
  • Phone: 817-478-6041
  • Fax:
Mailing address:
  • Phone: 718-613-4000
  • Fax: 718-613-4381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1148833
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number340053
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: