Provider Demographics
NPI:1255681227
Name:LANIPEKUN, ABIMBOLA OPEYEMI (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ABIMBOLA
Middle Name:OPEYEMI
Last Name:LANIPEKUN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:ABIMBOLA
Other - Middle Name:OPEYEMI
Other - Last Name:ADU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:407 KENT ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5858
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:407 KENT ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5858
Practice Address - Country:US
Practice Address - Phone:432-687-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX765309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX325298301Medicaid
TX287617YMF7Medicare PIN