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1104903574 NPI number — OGUNREMI OGUNLANA RN, MSN, PHN, FNP

NPI Number: 1104903574
Health Care Provider/Practitioner: OGUNREMI OGUNLANA RN, MSN, PHN, FNP

Information about “1104903574” NPI (OGUNREMI OGUNLANA RN, MSN, PHN, FNP) exists in 1104903574 in HTML format HTML  |  1104903574 in plain Text format TXT  |  1104903574 in PDF (Portable Document Format) PDF  |  1104903574 in an XML format XML  formats.

NPI Number : 1104903574 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104903574",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OGUNLANA",
    "FirstName": "OGUNREMI",
    "MiddleName": null,
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "RN, MSN, PHN, FNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "OGUNLANA",
    "OtherFirstName": "REMI",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RN, MSN, PHN, FNP",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "PO BOX 1681",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEWARK",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94560-6681",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "510-794-8538",
    "MailingAddressFaxNumber": "510-794-8538",
    "FirstLinePracticeLocationAddress": "5428 PORT SAILWOOD DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEWARK",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94560",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "510-794-8538",
    "PracticeLocationAddressFaxNumber": "510-794-8538",
    "EnumerationDate": "11/01/2006",
    "LastUpdateDate": "06/30/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "650782",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WC1500X",
          "TaxonomyName": "Community Health Registered Nurse",
          "LicenseNumber": "72319",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "17786",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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