Abimbola Datonye Iketubosin, FNP
Nurse Practitioner, Family in Chandler, AZ. Individual provider (NPI-1).
NPI number1356841514
StatusActive
Last updated in NPPESSep 18, 2026
Details
- NPI
- 1356841514
- Entity type
- Individual (NPI-1)
- Name
- Abimbola Datonye Iketubosin
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 14, 2018
- Certification date
- Sep 18, 2026
- Last updated
- Sep 18, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 221449 | AZ | Yes |
| 363LF0000X | Nurse Practitioner, Family | F08180855 | AZ | |
| 163WG0000X | Registered Nurse, General Practice | 221449 | AZ |
Practice location
501 W Ray Rd Ste 4Chandler, AZ 85225-7284
Phone 602-654-3802 · Fax 800-682-1416
Mailing address
Po Box 96770Phoenix, AZ 85072-6770
Phone 602-581-6076 · Fax 602-263-1619
Other practice locations
4212 N 16th St
Phoenix, AZ 85016-5319
Phoenix, AZ 85016-5319
Phone 602-263-1200 · Fax 602-263-1619
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