Provider Demographics
NPI:1982689071
Name:ALOBA, OLATUBOSUN (PHD, WHNP)
Entity Type:Individual
Prefix:DR
First Name:OLATUBOSUN
Middle Name:
Last Name:ALOBA
Suffix:
Gender:F
Credentials:PHD, WHNP
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2412 CASTELLO CT
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-9702
Mailing Address - Country:US
Mailing Address - Phone:973-476-1825
Mailing Address - Fax:
Practice Address - Street 1:WAKE COUNTY HUMAN SERVICES / HEALTH CLINICS
Practice Address - Street 2:10 SUNNYBROOK ROAD , NC
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-250-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007701363LW0102X
NJ26NN10395100363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ078622Medicaid
NJQ14773Medicare UPIN
NJQ14773Medicare ID - Type Unspecified