Provider Demographics
NPI:1992189856
Name:FOLUKE, OLUWASEUN KRYSTINA (CNP-BC)
Entity Type:Individual
Prefix:
First Name:OLUWASEUN
Middle Name:KRYSTINA
Last Name:FOLUKE
Suffix:
Gender:F
Credentials:CNP-BC
Other - Prefix:
Other - First Name:OLUWASEUN
Other - Middle Name:FOLUKE
Other - Last Name:KUTEYI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNP-BC
Mailing Address - Street 1:1394 CHESTERTON SQ N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2622
Mailing Address - Country:US
Mailing Address - Phone:301-379-1248
Mailing Address - Fax:
Practice Address - Street 1:5753 FOREST BIRCH LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3724
Practice Address - Country:US
Practice Address - Phone:301-379-1248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-10
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205021163W00000X
NY614563163W00000X
OHAPRN.CNP.0028073363LF0000X
OH414213163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily