Provider Demographics
NPI:1063712081
Name:KATIBI, OLANIKE (APRN-FNP)
Entity type:Individual
Prefix:
First Name:OLANIKE
Middle Name:
Last Name:KATIBI
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 NW LOOP 410 STE 700
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-2258
Mailing Address - Country:US
Mailing Address - Phone:210-441-6024
Mailing Address - Fax:210-783-8321
Practice Address - Street 1:1100 NW LOOP 410 STE 700
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-2258
Practice Address - Country:US
Practice Address - Phone:210-441-6024
Practice Address - Fax:210-783-8321
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX136598363L00000X
TXAP136598363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty