Bolajoko Alli

Individual provider Active NPI Pediatric Registered Nurse · Rosenberg, TX

NPI 1972086205 · NPPES record last updated Sep 12, 2018

Key facts

NPI
1972086205
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Registered Nurse 163WP0200X
License
889565 (TX)
Practice address
2111 Croxley CV
Rosenberg, TX 77471-4596
Phone
(301) 674-9139
NPI assigned
Sep 12, 2018
Sex
Female
Sole proprietor
No

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
889565TXMDPediatric Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 889565 TX Yes

Addresses

Primary practice location

2111 Croxley CV
Rosenberg, TX 77471-4596

Mailing address

2111 Croxley CV
Rosenberg, TX 77471-4596
Phone (301) 674-9139

Other providers in Rosenberg, TX

All providers in Rosenberg, TX · Pediatric Registered Nurse in Texas

Sources for this page

Verify at the official NPI Registry.