Provider Demographics
NPI:1306296967
Name:DAWODU, TEMITOPE ABIOLA (DNP, FNP, PMHNP- BC)
Entity type:Individual
Prefix:
First Name:TEMITOPE
Middle Name:ABIOLA
Last Name:DAWODU
Suffix:
Gender:F
Credentials:DNP, FNP, PMHNP- BC
Other - Prefix:
Other - First Name:TEMITOPE
Other - Middle Name:ABIOLA
Other - Last Name:ADEKUNLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4570 CHURCHILL ST STE 140
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-2274
Mailing Address - Country:US
Mailing Address - Phone:612-517-1293
Mailing Address - Fax:
Practice Address - Street 1:4570 CHURCHILL ST STE 140
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-2274
Practice Address - Country:US
Practice Address - Phone:612-517-1293
Practice Address - Fax:612-349-2790
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP4516363LP0808X
MNCNP 4516363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health