Healthcare Provider Details

I. General information

NPI: 1447503958
Provider Name (Legal Business Name): OLUREMILEKUN MARLENE OLORUNSOLA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REMI MARLENE OLORUNSOLA PMHNP-BC

II. Dates (important events)

Enumeration Date: 10/22/2012
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12650 CROSSROADS PARK DR STE 100
HOUSTON TX
77065-3371
US

IV. Provider business mailing address

12650 CROSSROADS PARK DR STE 100
HOUSTON TX
77065-3371
US

V. Phone/Fax

Practice location:
  • Phone: 832-380-4293
  • Fax:
Mailing address:
  • Phone: 832-380-4293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1207294
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number886889
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number662579
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: