Provider Demographics
NPI:1427355734
Name:OGUNLADE, IJEOMA JULIE (FNP-BC, CPON)
Entity type:Individual
Prefix:MS
First Name:IJEOMA
Middle Name:JULIE
Last Name:OGUNLADE
Suffix:
Gender:F
Credentials:FNP-BC, CPON
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BRITTON AVE
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-2578
Mailing Address - Country:US
Mailing Address - Phone:781-436-5696
Mailing Address - Fax:
Practice Address - Street 1:1025 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-4401
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:508-533-9475
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA266456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily