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General NPI Number Information
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NPI Number | 1437945995
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Entity Type | Individual
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Provider Name | TOLANI LYNAT OLATUNJI
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Gender |
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 2591 CANDLER RD
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City | DECATUR
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State | GA
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Zip | 30032-6502
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Country | US
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Telephone | 678-209-2710
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Fax |
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Provider Business Mailing Address
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Address Line | 581 SLEW DR
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City | CANTON
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State | GA
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Zip | 30115-3102
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Country | US
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Telephone | 224-518-4028
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN303630
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License Number State | GA
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