Provider Demographics
NPI:1346643657
Name:OKUNLOLA, OLUKEMI FLORENCE (DNP, MHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:OLUKEMI
Middle Name:FLORENCE
Last Name:OKUNLOLA
Suffix:
Gender:F
Credentials:DNP, MHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 WINTHROP ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-1483
Mailing Address - Country:US
Mailing Address - Phone:718-363-3040
Mailing Address - Fax:718-363-3044
Practice Address - Street 1:1040 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-1483
Practice Address - Country:US
Practice Address - Phone:718-363-3040
Practice Address - Fax:718-363-3040
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF401794363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health