Provider Demographics
NPI:1558328013
Name:OLADOKUN, FLORENCE ADENIKE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:FLORENCE
Middle Name:ADENIKE
Last Name:OLADOKUN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:65 N POTTEBAUM RD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-5326
Mailing Address - Country:US
Mailing Address - Phone:520-280-8999
Mailing Address - Fax:520-421-2877
Practice Address - Street 1:1142 E MCMURRAY BLVD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-3622
Practice Address - Country:US
Practice Address - Phone:520-421-7132
Practice Address - Fax:520-421-2877
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP0487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN089452OtherSTATE LICENSE
AZ318073Medicaid
AZAP0487OtherFAMILY NURSE PRACTITIONER