Provider Demographics
NPI:1508533548
Name:JESUFOWOKAN, OLUWAFEMI PETER
Entity Type:Individual
Prefix:DR
First Name:OLUWAFEMI
Middle Name:PETER
Last Name:JESUFOWOKAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5546 CAMINO AL NORTE # 2232
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0805
Mailing Address - Country:US
Mailing Address - Phone:407-529-6462
Mailing Address - Fax:
Practice Address - Street 1:5546 CAMINO AL NORTE # 2232
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-0805
Practice Address - Country:US
Practice Address - Phone:407-529-6462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion