Individual provider · Type 1 NPI
Samuel Olaoluwa Omolade, APRN PMHNP
Psychiatric/Mental Health Nurse Practitioner · Dallas, TX
NPI number
1548799141
Active
Practice location
11650 Mccree Rd
Dallas, TX 75238-5224
Mailing address
11650 Mccree Rd Apt 2034
Dallas, TX 75238-3245
Other practice locations
- 1904 Arnow Ave, Bronx, NY 10469-3334 · (718) 304-4906
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse | 164W00000X | 320878-1 (NY) |
| Administrator Registered Nurse | 163WA2000X | 958104 (TX) |
| Case Manager/Care Coordinator | 171M00000X | 958104 (TX) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP61366158 (WA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 1099855 (TX) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1548799141
Samuel Olaoluwa Omolade, APRN PMHNP's National Provider Identifier is 1548799141, issued on Jun 7, 2017. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Dallas, TX. The record was last updated on Jul 15, 2023.