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General NPI Number Information
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NPI Number | 1417718743
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Entity Type | Individual
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Provider Name | UDU OLADEINDE
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Gender | Female
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 11340 LAKESIDE DR, SUIT 200
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City | JOHNS CREEK
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State | GA
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Zip | 30097
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Country | US
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Telephone | 770-983-4084
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Fax | 404-726-3435
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Provider Business Mailing Address
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Address Line | 990 PEACHTREE INDUSTRIAL BLVD P.O.BOX 938
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City | SUWANEE
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State | GA
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Zip | 30024-9998
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Country | US
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Telephone | 770-983-4084
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN231481
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License Number State | GA
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