Provider Demographics
NPI:1730055120
Name:ADENEKAN, KIKELOMO BEATRICE (PMHNP)
Entity type:Individual
Prefix:
First Name:KIKELOMO
Middle Name:BEATRICE
Last Name:ADENEKAN
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 1:2021 GUADALUPE ST # 260
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-5654
Mailing Address - Country:US
Mailing Address - Phone:214-686-7909
Mailing Address - Fax:419-452-4265
Practice Address - Street 1:2021 GUADALUPE ST # 260
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-5654
Practice Address - Country:US
Practice Address - Phone:214-686-7909
Practice Address - Fax:419-452-4265
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-14
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1069927363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty