Provider Demographics
NPI:1518695691
Name:ADESANYA, OLUBANKE OLATUNDUN (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:OLUBANKE
Middle Name:OLATUNDUN
Last Name:ADESANYA
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:BANKE
Other - Middle Name:
Other - Last Name:ADESANYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, APRN, PMHNP-BC
Mailing Address - Street 1:4738 SADDLETOP RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-3850
Mailing Address - Country:US
Mailing Address - Phone:513-432-8917
Mailing Address - Fax:
Practice Address - Street 1:3615 SOCIAVILLE FOSTER ROAD, SUITE C
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-204-1910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH464340163WP0808X
OH0035334363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health