Provider Demographics
NPI:1558073858
Name:ADELAKUN, ADENIKE OLUWATOYIN (PMHNP)
Entity Type:Individual
Prefix:
First Name:ADENIKE
Middle Name:OLUWATOYIN
Last Name:ADELAKUN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E AIRPORT FWY
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-6351
Mailing Address - Country:US
Mailing Address - Phone:214-609-5608
Mailing Address - Fax:
Practice Address - Street 1:940 RED FOX
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-5124
Practice Address - Country:US
Practice Address - Phone:214-676-5109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1111480363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty