Provider Demographics
NPI:1740036474
Name:AINA, OLUWATOSIN ABIODUN (CRNP)
Entity type:Individual
Prefix:
First Name:OLUWATOSIN
Middle Name:ABIODUN
Last Name:AINA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1453 SHARON PARK DR
Mailing Address - Street 2:
Mailing Address - City:SHARON HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19079-2219
Mailing Address - Country:US
Mailing Address - Phone:215-900-9048
Mailing Address - Fax:
Practice Address - Street 1:1453 SHARON PARK DR
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079-2219
Practice Address - Country:US
Practice Address - Phone:215-900-9048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029610363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty