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Contact Information

OLIVIA T AGBOOLA
135 HENRY PKWY
MCDONOUGH, GA30253-6636
 Phone: 770-288-6155
 Fax: 770-954-2269
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for OLIVIA T AGBOOLA · (Female)

NPI # 1568022671
Status Active
Credentials
Entity Individual
Enumeration date 06/20/2019
Last updated 06/20/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # RN209875
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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