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MRS. OLUBUNMI TINA AYENI NP

Primary Care >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1508482746

Individual Registrant:
MRS. OLUBUNMI TINA AYENI NP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
2759 MOUNT ZION PKWY  JONESBORO, GA 30236-2568 US
Tel: 678-289-8338  Fax: 770-603-0515

Contact information for business:
2759 MOUNT ZION PKWY  JONESBORO, GA 30236-2568 US
Tel: 678-289-8338  Fax: 770-603-0515

Registration Information:
NPI: 1508482746
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LP2300XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Primary Care
GARN174210

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
ADVANCED PRACTICE LICENSERN174210GA01




HEALTH CARE JOBS GA - Page 1



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