Provider Demographics
NPI:1356818421
Name:KEKERE, OLANIKE OYEYEMI (APRN)
Entity type:Individual
Prefix:
First Name:OLANIKE
Middle Name:OYEYEMI
Last Name:KEKERE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:OLANIKE
Other - Middle Name:OYEYEMI
Other - Last Name:IDOWU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:397 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5292
Mailing Address - Country:US
Mailing Address - Phone:475-441-3924
Mailing Address - Fax:
Practice Address - Street 1:397 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5292
Practice Address - Country:US
Practice Address - Phone:475-441-3924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007822363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health