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NPI Code Detail

MEDICARE: LILIAN ENIBOKUN BAMGBOSE MSN, APRN, PMHNP-BC

MEDICARE: LILIAN ENIBOKUN BAMGBOSE MSN, APRN, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerSP031251PA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner209.032298IL
3363LP0808XPsychiatric/Mental Health Nurse Practitioner313608AZ
4363LP0808XPsychiatric/Mental Health Nurse Practitioner0024191293VA
5363LP0808XPsychiatric/Mental Health Nurse Practitioner4024429KY
6363LP0808XPsychiatric/Mental Health Nurse Practitioner851709NV
7363LP0808XPsychiatric/Mental Health Nurse Practitioner220580OK
8363LP0808XPsychiatric/Mental Health Nurse Practitioner1028759TX
9363LP0808XPsychiatric/Mental Health Nurse PractitionerGAA-NP002294GA
10363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11027775FL
11363LP0808XPsychiatric/Mental Health Nurse Practitioner4704416257MI
12363LP0808XPsychiatric/Mental Health Nurse Practitioner26NJ15349500NJ
13363LP0808XPsychiatric/Mental Health Nurse Practitioner95020084CA
14363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN.CNP.0036305OH
15363LP0808XPsychiatric/Mental Health Nurse Practitioner237487LA

General Provider Information

NPI Number : 1538750559
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILIAN ENIBOKUN BAMGBOSE MSN, APRN, PMHNP-BC
Provider Business Mailing Address
First Line : 3227 MEADE AVE STE 5B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-7810
Country : US
Telephone Number : 725-333-2411
Fax Number : 702-952-5257
Provider Business Practice Location Address
First Line : 800 N RAINBOW BLVD STE 215
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-1189
Country : US
Telephone Number : 800-950-0026
Fax Number : 702-952-5257
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2021
Last Update Date : 05/11/2026

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