Provider Demographics
NPI:1356056279
Name:SOKUNBI-JONES, OLUYEMISI OMOLARA
Entity type:Individual
Prefix:
First Name:OLUYEMISI
Middle Name:OMOLARA
Last Name:SOKUNBI-JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ENDWELL LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-2332
Mailing Address - Country:US
Mailing Address - Phone:908-338-6015
Mailing Address - Fax:
Practice Address - Street 1:18 ENDWELL LN
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-2332
Practice Address - Country:US
Practice Address - Phone:908-338-6015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY863900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse