Provider Demographics
NPI:1316449275
Name:OJIFINNI, IBUKUN OLUWATOSIN (ARNP)
Entity type:Individual
Prefix:
First Name:IBUKUN
Middle Name:OLUWATOSIN
Last Name:OJIFINNI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:IBUKUN
Other - Middle Name:OLUWATOSIN
Other - Last Name:FATOKUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 2148
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82902-2148
Mailing Address - Country:US
Mailing Address - Phone:307-362-5116
Mailing Address - Fax:307-362-5145
Practice Address - Street 1:2620 COMMERCIAL WAY STE 120
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-4746
Practice Address - Country:US
Practice Address - Phone:307-362-5116
Practice Address - Fax:307-362-5145
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY38524.1714363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner