Provider Demographics
NPI:1033155486
Name:GLENN OLAJIDE, TUJUANA C (RN, NP)
Entity Type:Individual
Prefix:MRS
First Name:TUJUANA
Middle Name:C
Last Name:GLENN OLAJIDE
Suffix:
Gender:F
Credentials:RN, NP
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Mailing Address - Street 1:5404 TREE SUMMIT PKWY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8070
Mailing Address - Country:US
Mailing Address - Phone:678-477-3397
Mailing Address - Fax:678-417-9151
Practice Address - Street 1:5404 TREE SUMMIT PKWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8070
Practice Address - Country:US
Practice Address - Phone:678-477-3397
Practice Address - Fax:678-417-9151
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2013-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704180693363LP0200X
GA119695363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704180693OtherLICENSE
MA4868152Medicaid