Provider Demographics
NPI:1598247108
Name:SOMORIN, OLATUNBOSUN ADENIKE (RN)
Entity Type:Individual
Prefix:MRS
First Name:OLATUNBOSUN
Middle Name:ADENIKE
Last Name:SOMORIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11227 BALMULLO CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-1882
Mailing Address - Country:US
Mailing Address - Phone:469-685-2529
Mailing Address - Fax:
Practice Address - Street 1:11227 BALMULLO CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-1882
Practice Address - Country:US
Practice Address - Phone:469-264-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX859292163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice