Olufunmilayo Temitope Ajala
Nurse Practitioner, Psych/Mental Health in Snellville, GA. Individual provider (NPI-1).
NPI number1750033684
StatusActive
Last updated in NPPESOct 19, 2023
Details
- NPI
- 1750033684
- Entity type
- Individual (NPI-1)
- Name
- Olufunmilayo Temitope Ajala
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 21, 2022
- Certification date
- Oct 19, 2023
- Last updated
- Oct 19, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | RN222212 | GA | Yes |
| 163WM0705X | Registered Nurse, Medical-Surgical | RN222212 | GA | |
| 163WG0000X | Registered Nurse, General Practice | RN222212 | GA |
Practice location
2121 Fountain Dr Ste DSnellville, GA 30078-2900
Phone 470-435-5341
Mailing address
2121 Fountain Dr Ste DSnellville, GA 30078-2900
Phone 470-435-5341
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