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General NPI Number Information
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NPI Number | 1770148397
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Entity Type | Individual
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Provider Name | OLUSOLA ABOSEDE OPESEITAN-ODUMOSU NP-C
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Gender | Female
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 451 E ALMOND AVE STE 103
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City | MADERA
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State | CA
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Zip | 93637-5562
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Country | US
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Telephone | 559-673-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2059 E ECLIPSE AVE
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City | FRESNO
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State | CA
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Zip | 93720-4615
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Country | US
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Telephone | 559-273-0316
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Fax | 559-433-0750
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95011163
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License Number State | CA
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