Provider Demographics
NPI:1346956109
Name:AINA, FUNMILAYO A (FNP)
Entity Type:Individual
Prefix:MRS
First Name:FUNMILAYO
Middle Name:A
Last Name:AINA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 CCA RD
Mailing Address - Street 2:
Mailing Address - City:LUMPKIN
Mailing Address - State:GA
Mailing Address - Zip Code:31815-3823
Mailing Address - Country:US
Mailing Address - Phone:706-289-8837
Mailing Address - Fax:
Practice Address - Street 1:146 CCA RD
Practice Address - Street 2:
Practice Address - City:LUMPKIN
Practice Address - State:GA
Practice Address - Zip Code:31815-3823
Practice Address - Country:US
Practice Address - Phone:706-289-8837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF01231104363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily