Oluwatosin B Ajibola
Nurse Practitioner, Family in Grand Prairie, TX. Individual provider (NPI-1).
NPI number1063230464
StatusActive
Last updated in NPPESSep 4, 2025
Details
- NPI
- 1063230464
- Entity type
- Individual (NPI-1)
- Name
- Oluwatosin B Ajibola
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 3, 2024
- Certification date
- Sep 4, 2025
- Last updated
- Sep 4, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 1177043 | TX | Yes |
Practice location
4927 Lake Ridge Pkwy Ste 148Grand Prairie, TX 75052-3000
Phone 972-217-4203
Mailing address
4927 Lake Ridge Pkwy Ste 148Grand Prairie, TX 75052-3000
Phone 972-217-4203
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