Bolanle Tinuke Amon, FCNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP012757 Issued in PA

Practice address

725 Wicker Ave
Suite 202
Bensalem, PA 19020-7251

Phone

(215) 639-4646

Fax

(215) 639-2323

NPI assigned

May 3, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Bola Tinuke Amon Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

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  • NPI 1134927874
  NPD Authorized official
• Kindest Care Healthcare LLC

  • Home Health Agency
  • Bensalem, PA
  • NPI 1356580393
  NPD (past)

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367539200000",
    "number": "1972948966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WICKER AVE",
            "address_2": "SUITE 202",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190207251",
            "telephone_number": "215-639-4646",
            "fax_number": "215-639-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WICKER AVE",
            "address_2": "SUITE 202",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190207251",
            "telephone_number": "215-639-4646",
            "fax_number": "215-639-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMON",
        "first_name": "BOLANLE",
        "middle_name": "TINUKE",
        "credential": "FCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2013-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "568664",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR11110200",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP012757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESCRIPTIVE AUTHORITY (BUREAU OF PROFESSIONAL & OCCUPATIONAL AFFAIRS)",
            "identifier": "017673",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA CERTIFIED REGISTERED NURSE PRACTIONER (FAMILY HEALTH)",
            "identifier": "SP012757",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "568664",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOLA",
            "last_name": "AMON",
            "middle_name": "TINUKE",
            "credential": "FCNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Family Nurse Practitioner in Bensalem, PA
• Providers in Bensalem, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; 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.