IBUKUN ODUTOLA (NPI# 1801404074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801404074 |
| Entity Type | Individual |
| Full Name | IBUKUN ODUTOLA |
| Practice Address |
2605 E Flamingo Rd Las Vegas NV 89121-5241 |
| Mailing Address |
2505 Anthem Village Dr Ste E101 Henderson NV 89052-5505 |
| Practice Telephone | 7027031950 |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
244759 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
810773 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2605 E FLAMINGO RD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89121-5241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598379117 | Western State Behavioral Health and Psychiatric Services | Psychologist | 3910 Pecos-mcleod Interconnect, Las Vegas, NV 89121 | 2020-09-01 |
| 1962025155 | Arieste Diaz Perez | Clinic/Center | 3777 Pecos-mcleod Interconnect, Suite 101, Las Vegas, NV 89121 | 2020-05-21 |
| 1366071904 | Vanesa Silva | Behavior Technician | 4714 Flamigo Rd, Las Vegas, NV 89121 | 2020-04-06 |
| 1053955732 | Valente Solis Santiago | Technician | 2785 E. Desert Inn Rd Ste. 240, Las Vegas, NV 89121 | 2019-11-05 |
| 1750938981 | Ken Ernst | Rehabilitation Practitioner | Primary Solutions Medical Billing, 4525 S. Sandhill Rd Ste #112, Las Vegas, NV 89121 | 2019-08-22 |
| 1902450455 | Tracey Anora Henry | Counselor | 3675 Pecos Mecleod Ste 900, Las Vegas, NV 89121 | 2019-08-01 |
| 1679127096 | Wilma Guadalupe Nunez | Chore Provider | 2860 East Flamingo, Suite C, Las Vegas, NV 89121 | 2019-07-25 |
| 1487213807 | Karla Susana Ayala | Chore Provider | 2860 E. Flamingo Rd Ste K., Las Vegas, NV 89121 | 2019-06-10 |
| 1447819164 | Jovita Garcia-perez | Chore Provider | 2860 E. Flamingo Suite C, Suite C, Las Vegas, NV 89121 | 2019-06-06 |
| 1164081972 | Maria Isabel Castellanos Gonzalez | Chore Provider | 2860 E. Flamingo Rd Ste K, Las Vegas, NV 89121 | 2019-06-06 |
| Find all providers in zip 89121 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225652191 | Angela Beth Wilson | Nurse Practitioner | 5440 W Sahara Ave Ste 220, Las Vegas, NV 89146-0355 | 2020-06-05 |
| 1104445394 | Universal Psychiatry LLC | Nurse Practitioner | 270 E Flamingo Rd Unit 122, Las Vegas, NV 89169-0325 | 2020-04-09 |
| 1952931271 | Paramount Healthcare Services Corp | Nurse Practitioner | 10141 Rockridge Peak Ave, Las Vegas, NV 89166-5200 | 2020-01-26 |
| 1730642182 | Aban Medical Services | Nurse Practitioner | 10145 Eagle Haven St, Las Vegas, NV 89141-8781 | 2019-04-11 |
| 1750857728 | Jan Michael Arceo | Nurse Practitioner | 3140 S Rainbow Blvd Ste 401, Las Vegas, NV 89146-6234 | 2018-10-17 |
| 1780110247 | Jon A Failla Aprn Pllc | Nurse Practitioner | 182 Apache Tear Ct, Las Vegas, NV 89123-2996 | 2017-05-03 |
| 1023565074 | Bright Star Nurse Care LLC | Nurse Practitioner | 8337 Fox Brook St, Las Vegas, NV 89139-6755 | 2016-09-07 |
| 1467805119 | Kasey James Dean | Nurse Practitioner | 3321 N Buffalo Dr, Suite 200, Las Vegas, NV 89129-6678 | 2016-07-18 |
| 1558757021 | Martin Binyange | Nurse Practitioner | 320 E Warm Springs Rd Unit 1, Las Vegas, NV 89119-4243 | 2015-04-12 |
| 1184026684 | Ngozi Ugwu | Nurse Practitioner | 601 S Rancho Dr Ste D29, Las Vegas, NV 89106-4827 | 2014-09-16 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.