Provider Demographics
NPI:1922688019
Name:BODE-OLOYE, ANUOLUWAPO TEMITOPE
Entity Type:Individual
Prefix:MRS
First Name:ANUOLUWAPO
Middle Name:TEMITOPE
Last Name:BODE-OLOYE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ANUOLUWAPO
Other - Middle Name:TEMITOPE
Other - Last Name:IJAOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:223 AUBURN SHORES CT
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4001
Mailing Address - Country:US
Mailing Address - Phone:240-743-6185
Mailing Address - Fax:
Practice Address - Street 1:223 AUBURN SHORES CT
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77469-4001
Practice Address - Country:US
Practice Address - Phone:240-743-6185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1030222363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health