Provider Demographics
NPI:1760684443
Name:OLATUNJI, OLUFEMI S (BSN,RN,C)
Entity Type:Individual
Prefix:
First Name:OLUFEMI
Middle Name:S
Last Name:OLATUNJI
Suffix:
Gender:M
Credentials:BSN,RN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 FLORENCE FIELDS LN
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-8752
Mailing Address - Country:US
Mailing Address - Phone:302-323-1892
Mailing Address - Fax:302-995-1859
Practice Address - Street 1:505 FLORENCE FIELDS LN
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-8752
Practice Address - Country:US
Practice Address - Phone:302-323-1892
Practice Address - Fax:302-995-1859
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL10031564163W00000X
NY540403163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse