Most Relevant Information
Provider Data
| NPI Number: | 1003561705 |
| Provider Name: | OLUFEMI OLAWALE FANUSI |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | RN285470 |
Most Important Dates
| Enumeration Date: | 02/21/2022 |
| Last Updated: | 02/21/2022 |
Provider Practice Location
4202 KENSINGTON CIR
STONECREST
GA
300383239
Practice Location Phone/Fax
| Phone: | 6786809209 |
| Fax: |
Provider Mailing Location
4202 KENSINGTON CIR
STONECREST
GA
300383239
Provider Mailing Phone/Fax
| Phone: | 6786809209 |
| Fax: |