MEDICARE: OLUWATOMISIN OLAYINKA

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	363LF0000X	Family Nurse Practitioner	RN2265530	MA
2	363LF0000X	Family Nurse Practitioner	1195994	TX
3	363LC0200X	Critical Care Medicine Nurse Practitioner	1195994	TX

General Provider Information

NPI Number	:	1649818832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWATOMISIN OLAYINKA

Provider Business Mailing Address
First Line	:	PO BOX 746079
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6079
Country	:	US
Telephone Number	:	773-352-1515
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 LITTLE YORK RD STE A5
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-3658
Country	:	US
Telephone Number	:	281-707-7358
Fax Number	:

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

Provider Enumeration Date	:	12/18/2019
Last Update Date	:	01/14/2026

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