MEDICARE: OLUWAKENKE BEN-ASEMOTA

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN256600	GA

General Provider Information

NPI Number	:	1366050312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWAKENKE BEN-ASEMOTA

Provider Business Mailing Address
First Line	:	PO BOX 4222
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30023-4222
Country	:	US
Telephone Number	:	404-423-2130
Fax Number	:	678-621-7463

Provider Business Practice Location Address
First Line	:	945 N POINT DR # 1232
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-8266
Country	:	US
Telephone Number	:	678-600-1257
Fax Number	:	678-621-7463

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

Provider Enumeration Date	:	07/15/2020
Last Update Date	:	06/23/2026

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Directions to “ OLUWAKENKE BEN-ASEMOTA ” Practice Location

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