Olubunmi Mutiat Aziaka

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9517579 Issued in FL

Practice address

1900 E Main St
Danville, IL 61832-5100

Phone

(217) 554-3000

Fax

(217) 554-3370

NPI assigned

Sep 2, 2021

Last updated

Sep 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1912675901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E MAIN ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325100",
            "telephone_number": "217-554-3000",
            "fax_number": "217-554-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E MAIN ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325100",
            "telephone_number": "217-554-3000",
            "fax_number": "217-554-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIAKA",
        "first_name": "OLUBUNMI",
        "middle_name": "MUTIAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "041358697",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28250636A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9517579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "olubunmi.aziaka@va.gov",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "address_1": "1900 E Main St",
            "city": "Danville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618325100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Sadie Baird, RD
• Michelle Baker
• Alyanna Kim Balanay Dimla, APRN

• Psychiatric/Mental Health Nurse Practitioner in Danville, IL
• Providers in Danville, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.