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General NPI Number Information
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NPI Number | 1104287283
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Entity Type | Individual
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Provider Name | OLAWUNMI OGUN-SEMORE
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Gender | Female
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 11815 NORTHFALL LN STE 1001
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City | ALPHARETTA
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State | GA
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Zip | 30009-7973
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Country | US
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Telephone | 425-659-5073
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Fax | 770-502-6956
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Provider Business Mailing Address
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Address Line | 11815 NORTHFALL LN STE 1001
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City | ALPHARETTA
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State | GA
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Zip | 30009-7973
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Country | US
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Telephone | 425-659-5073
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Fax | 770-502-6956
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 182005
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | RN182005
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 182005
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License Number State | GA
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