Individual provider · Type 1 NPI

Kemisola Lynda Ebietomiye

Psychiatric/Mental Health Nurse Practitioner · New York, NY

NPI number 1255102976 Active

Practice location

274 Madison Ave Rm 1501
New York, NY 10016-0701

Call (212) 203-1773 Map

Fax (646) 665-4427

Mailing address

548 Westwood Way Dr
Haslet, TX 76052-3079

Other practice locations

  • 801 7th Ave, Fort Worth, TX 76104-2733 · (773) 621-8983
  • 2 University Plz Ste 100, Hackensack, NJ 07601-6210 · (212) 203-1773

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner 363LP0808X1149539 (TX)
Psychiatric/Mental Health Nurse Practitioner 363LP0808X26NJ15047800 (NJ)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X405625 (NY)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1255102976

Kemisola Lynda Ebietomiye's National Provider Identifier is 1255102976, issued on Jan 11, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in New York, NY. The record was last updated on Jul 7, 2025.