Provider Demographics
NPI:1427682418
Name:OGUNMEFUN, ADETUTU ZAINAB (FNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ADETUTU
Middle Name:ZAINAB
Last Name:OGUNMEFUN
Suffix:
Gender:F
Credentials:FNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 PLANTATION RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3207
Mailing Address - Country:US
Mailing Address - Phone:201-887-2548
Mailing Address - Fax:
Practice Address - Street 1:933 N WASHINGTON AVE STE 2C
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812-2600
Practice Address - Country:US
Practice Address - Phone:908-285-0622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01004300363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily