Provider Demographics
NPI:1437735222
Name:OLATUNJI, SAMUEL OLUWAFEMI (REGISTERED NURSE, RN)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:OLUWAFEMI
Last Name:OLATUNJI
Suffix:
Gender:M
Credentials:REGISTERED NURSE, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 FLORENCE FIELDS LN
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-8752
Mailing Address - Country:US
Mailing Address - Phone:302-561-3577
Mailing Address - Fax:
Practice Address - Street 1:505 FLORENCE FIELDS LN
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-8752
Practice Address - Country:US
Practice Address - Phone:302-561-3577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0066487163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse