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Contact Information

FAKAYATU I AGBOOLA
175 GWINNETT DR
LAWRENCEVILLE, GA30046-8444
 Phone: 678-209-2396
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for FAKAYATU I AGBOOLA · (Female)

NPI # 1306572821
Status Active
Credentials
Entity Individual
Enumeration date 07/27/2022
Last updated 07/27/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2021007170
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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