Olubukola Adetoye

Individual provider Active NPI Registered Nurse · Dacula, GA

NPI 1376083535 · NPPES record last updated Mar 7, 2025

Key facts

NPI
1376083535
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN194402 (GA)
Practice address
2997 Overlook Hill Pass
Dacula, GA 30019-5106
Phone
(678) 896-8343
NPI assigned
Mar 6, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN194402GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Family and Community Services Limited Nursing Care Current
since Aug 1, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X
Registered Nurse 163W00000X RN194402 GA Yes

Addresses

Primary practice location

2997 Overlook Hill Pass
Dacula, GA 30019-5106

Mailing address

2997 Overlook Hill Pass
Dacula, GA 30019-5106
Phone (678) 659-9287

Other providers in Dacula, GA

All providers in Dacula, GA · Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.