Provider Demographics
NPI:1386218113
Name:OSHUN, DEEN OWOLABI (NP)
Entity type:Individual
Prefix:
First Name:DEEN
Middle Name:OWOLABI
Last Name:OSHUN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 EUTAW AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-2106
Mailing Address - Country:US
Mailing Address - Phone:574-170-0458
Mailing Address - Fax:
Practice Address - Street 1:64 EUTAW AVE
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-2106
Practice Address - Country:US
Practice Address - Phone:857-417-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2269344163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse