Provider Demographics
NPI:1730732314
Name:OLOTU, OLUWAKEMI (NP)
Entity type:Individual
Prefix:MISS
First Name:OLUWAKEMI
Middle Name:
Last Name:OLOTU
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:960 MASSACHUSETTS AVENUE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:732 HARRISON AVE, FL 3 WEST
Practice Address - Street 2:PRESTON BLDG.
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-7350
Practice Address - Fax:617-638-7228
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2024-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN237425207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine