MRS. ADEBOLA OMOLARA ILESANMI (NPI# 1285784033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285784033 |
| Entity Type | Individual |
| Full Name | MRS. ADEBOLA OMOLARA ILESANMI |
| Credential | FNP |
| Practice Address |
601 S Martin Luther King Jr Dr Room 244 Winston Salem NC 27110-0001 |
| Mailing Address |
601 South M.l.k. Jr. Drive Room 244 Winston Salem NC 27110-0001 |
| Practice Telephone | 3367503300 |
| Practice Fax Number | 3367503303 |
| Mailing Telephone | 3367503300 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2009-01-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201969 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
601 S MARTIN LUTHER KING JR DR ROOM 244 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27110-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629005657 | Darrell Matthew Turner | Specialist/Technologist | 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 | 2006-06-26 |
| 1265047161 | Hannah Martin | Occupational Therapist | 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0001 | 2020-09-09 |
| 1033723077 | Brittany Dixon | Occupational Therapist | 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 | 2020-09-08 |
| 1316552243 | Sheniah Campbell | Occupational Therapist | 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0001 | 2020-09-08 |
| 1942815873 | Jaiven Knight | Occupational Therapist | 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 | 2020-09-08 |
| 1235743204 | Troy Jones | Occupational Therapist | 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 | 2020-09-07 |
| 1194339192 | Jonathan Brown | Occupational Therapist | 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 | 2020-09-07 |
| 1013521079 | Jonelle Claricia Bedford | Occupational Therapist | 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 | 2020-09-06 |
| 1033723267 | Savannah K Dorman | Occupational Therapist | 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 | 2020-09-04 |
| 1902410079 | Greyson Ray | Occupational Therapist | 601 S Martin Luther King Jr Dr, Winston Salem, NC 27110-0003 | 2020-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652454 | Erica Shade | Occupational Therapist | 601 Martin Luther King Jr. Dr, 432 Fl Atkins Building, Winston-salem, NC 27110 | 2020-09-05 |
| 1841804838 | Lisa Hartwell | Occupational Therapist | 601 Martin Luther King Jr. Dr, 432 Fl Atkins Building, Winston-salem, NC 27110 | 2020-09-07 |
| 1801140702 | Dina Vallabh | Speech-Language Pathologist | 155 Baker House Trent Drive, Durham, NC 27110 | 2012-10-31 |
| 1386258432 | Valerie Miller | Student in an Organized Health Care Education/Training Program | 601 Mlk Jr Dr, Winston Salem, NC 27110-0001 | 2020-09-05 |
| 1942814074 | Joyous Hawkins | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King, Winston Salem, NC 27110-0001 | 2020-09-05 |
| 1306450408 | Katlyn Maiolo | Occupational Therapist | 601 Martin Luther King Jr. Drive, 432 Fl Atkins Building, Winston-salem, NC 27110-0001 | 2020-09-04 |
| 1649884701 | Lila Grafius | Occupational Therapist | 601 Martin Luther King Dr 432 Fl Atkins Building, Winston Salem, NC 27110-0001 | 2020-09-04 |
| 1326652504 | Emily Claire Skoglund | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0001 | 2020-09-03 |
| 1366927659 | Judy Larose Foxworth | Physical Therapist | 601 S Mlk Jr Drive F L Atkins Bldg Rm 333, Winston Salem, NC 27110-0001 | 2018-10-02 |
| 1285138123 | Jessica Um | Occupational Therapist | 601 Martin Luther King Jr Dr, 432 Fl Atkins Building, Winston-salem, NC 27110-0001 | 2018-03-23 |
| Find all providers in zip 27110 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619576857 | Candace Allen | Nurse Practitioner | 1215 W Clemmonsville Rd, Winston Salem, NC 27127-4521 | 2020-10-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1427604883 | Jeanette Renea Torain | Nurse Practitioner | 145 Kimel Park Dr Ste 100, Winston Salem, NC 27103-6983 | 2019-08-12 |
| 1841853876 | Sarah Monzella Pack | Nurse Practitioner | 3878 Oxford Station Way Ste A, Winston Salem, NC 27103-1340 | 2019-04-16 |
| 1720547425 | Ya Huster Taylor | Nurse Practitioner | 1005 Treble Ct, Winston Salem, NC 27127-5971 | 2019-03-13 |
| 1710450127 | Assumpta Kagaba | Nurse Practitioner | 3811 White Petals Ct, Winston Salem, NC 27107-6052 | 2019-01-08 |
| 1982189460 | Erica Segers | Nurse Practitioner | 4157 Kennison Village Dr, Winston Salem, NC 27127-6694 | 2018-10-01 |
| 1710433495 | Ikeshia Knight | Nurse Practitioner | 1831 Cahill Dr, Winston Salem, NC 27127-8828 | 2016-08-31 |
| 1487023495 | Porcial Washington Wilson | Nurse Practitioner | 755 Highland Oaks Dr Ste 202, Winston Salem, NC 27103-7106 | 2015-09-20 |
| 1316323124 | Elizabeth Arpe Goodman | Nurse Practitioner | 191 Wallburg High Point Rd, Winston Salem, NC 27107-9835 | 2015-08-04 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27110 |
Please comment or provide details below to improve the information on MRS. ADEBOLA OMOLARA ILESANMI.
| 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.