Provider Demographics
NPI:1942765151
Name:ADAMS, TAIWO OLANIKE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:TAIWO
Middle Name:OLANIKE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:NIKE
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18651 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:92316-1831
Mailing Address - Country:US
Mailing Address - Phone:909-546-7520
Mailing Address - Fax:
Practice Address - Street 1:18651 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:CA
Practice Address - Zip Code:92316-1831
Practice Address - Country:US
Practice Address - Phone:909-546-7520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008108363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily