Provider Demographics
NPI:1316604861
Name:OLAWUNMI, MUTIAT TEMITOPE (NP)
Entity type:Individual
Prefix:DR
First Name:MUTIAT
Middle Name:TEMITOPE
Last Name:OLAWUNMI
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18403 AUSTIN OAK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2277
Mailing Address - Country:US
Mailing Address - Phone:281-258-5344
Mailing Address - Fax:
Practice Address - Street 1:18403 AUSTIN OAK LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2277
Practice Address - Country:US
Practice Address - Phone:281-258-5344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM68094363LP0808X
WA61530158363LP0808X
TX1060110363LP0808X
OR202208555363LP0808X
CA95023833363LP0808X
CO0103592364SP0809X
NY404116363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty