Provider Demographics
NPI:1992386304
Name:OPALEYE, OLAJIDE ABIODUN (APRN)
Entity Type:Individual
Prefix:
First Name:OLAJIDE
Middle Name:ABIODUN
Last Name:OPALEYE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 DALLAS HWY STE 200-134
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-6318
Mailing Address - Country:US
Mailing Address - Phone:470-593-8652
Mailing Address - Fax:
Practice Address - Street 1:4170 OLD AUSTELL RD
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-2691
Practice Address - Country:US
Practice Address - Phone:678-521-8115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN141925363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health