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General NPI Number Information
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NPI Number | 1174340186
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Entity Type | Individual
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Provider Name | FOLAYEMI OLUBUSAYO GANIYU NP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2024
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 11155 DUNN RD STE 309E
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6111
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Country | US
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Telephone | 314-953-8788
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Fax | 314-953-8798
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Provider Business Mailing Address
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Address Line | PO BOX 959203
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City | SAINT LOUIS
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State | MO
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Zip | 63195-9203
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Country | US
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Telephone | 314-953-8788
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Fax | 314-953-8798
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 20242029786
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 2024029786
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License Number State | MO
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