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General NPI Number Information
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NPI Number | 1922842525
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Entity Type | Individual
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Provider Name | LATEEFAT EBUDOLA ODUBOTE DNP. ARNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/20/2024
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 7700 HICKMAN RD
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City | DES MOINES
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State | IA
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Zip | 50324-4512
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Country | US
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Telephone | 515-207-6251
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Fax |
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Provider Business Mailing Address
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Address Line | 2837 SW PLAZA LN
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City | ANKENY
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State | IA
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Zip | 50023-7286
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Country | US
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Telephone | 404-839-6746
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A182165
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License Number State | IA
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