Individual provider · NPI-1

Adeola Sarah Adewusi

Nurse Practitioner, Gerontology · Detroit, MI

NPI number1730806506
StatusActive
Last updated in NPPESMar 27, 2026

Details

NPI
1730806506
Entity type
Individual (NPI-1)
Name
Adeola Sarah Adewusi
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 24, 2022
Certification date
Mar 27, 2026
Last updated
Mar 27, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LG0600X Nurse Practitioner, Gerontology4704287149MIYes
163W00000X Registered Nurse4704287149MI

Practice location

4646 John R St
Detroit, MI 48201-1916

Phone 313-576-4242

Mailing address

4646 John R St
Detroit, MI 48201-1916

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