Provider Demographics
NPI:1750784344
Name:JUBRIL, ALEX OLAWALE (DNP)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:OLAWALE
Last Name:JUBRIL
Suffix:
Gender:
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5320 HOLIDAY TER
Mailing Address - Street 2:SUITE 7 E
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-2100
Mailing Address - Country:US
Mailing Address - Phone:269-459-1270
Mailing Address - Fax:269-459-8200
Practice Address - Street 1:5320 HOLIDAY TER
Practice Address - Street 2:SUITE 7 E
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2100
Practice Address - Country:US
Practice Address - Phone:269-459-1270
Practice Address - Fax:269-459-8200
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704276056163W00000X, 363LP0808X, 363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care