Healthcare Provider Details

I. General information

NPI: 1619782885
Provider Name (Legal Business Name): CAROLINE AWOSIKA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OYEJOLA OLAKUNLE

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2266 N PROSPECT AVE STE 304
MILWAUKEE WI
53202-6306
US

IV. Provider business mailing address

2022 E EDGEWOOD AVE
SHOREWOOD WI
53211-2935
US

V. Phone/Fax

Practice location:
  • Phone: 414-405-0670
  • Fax: 608-305-2626
Mailing address:
  • Phone: 414-405-0670
  • Fax: 608-305-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number16473
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number16473
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: