Provider Demographics
NPI:1891273199
Name:AFOLAMI, FATIMOH OLAWUMI (LVN)
Entity Type:Individual
Prefix:
First Name:FATIMOH
Middle Name:OLAWUMI
Last Name:AFOLAMI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:FATIMOH
Other - Middle Name:FOLASADE
Other - Last Name:OLAWUMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LVN
Mailing Address - Street 1:602 W SEMANDS ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1867
Mailing Address - Country:US
Mailing Address - Phone:936-756-5598
Mailing Address - Fax:
Practice Address - Street 1:602 W SEMANDS ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1867
Practice Address - Country:US
Practice Address - Phone:936-756-5598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX233842164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse