Provider Demographics
NPI:1083127500
Name:FOLARINDE, BUNMI YEMISI (PHD, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:BUNMI
Middle Name:YEMISI
Last Name:FOLARINDE
Suffix:
Gender:F
Credentials:PHD, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3616 S BOGAN RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4310
Mailing Address - Country:US
Mailing Address - Phone:678-288-9740
Mailing Address - Fax:678-288-9779
Practice Address - Street 1:3616 S BOGAN RD STE 202
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519
Practice Address - Country:US
Practice Address - Phone:404-333-7652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA214997363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003213060AMedicaid