MEDICARE: BOLA ONISSEMA KARIMU MSN, APRN, AGNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WG0600X	Gerontology Registered Nurse	26NJ15426800	NJ

General Provider Information

NPI Number	:	1205793890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOLA ONISSEMA KARIMU MSN, APRN, AGNP-C

Provider Business Mailing Address
First Line	:	321 E 3RD ST APT 413
Second Line	:
City	:	PLAINFIELD
State	:	NJ
Zip	:	07060-2467
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 E 3RD ST APT 413
Second Line	:
City	:	PLAINFIELD
State	:	NJ
Zip	:	07060-2467
Country	:	US
Telephone Number	:	856-408-9501
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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