Provider Demographics
NPI:1467166439
Name:AKINKUNMI, ADEBUKOLA G (FNP)
Entity Type:Individual
Prefix:
First Name:ADEBUKOLA
Middle Name:G
Last Name:AKINKUNMI
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 1:1322 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2926
Mailing Address - Country:US
Mailing Address - Phone:718-302-7336
Mailing Address - Fax:
Practice Address - Street 1:1322 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-2926
Practice Address - Country:US
Practice Address - Phone:929-354-4456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily