Mutiat Ajibade, NURSEPRACTITIONER
Mutiat Ajibade, NURSEPRACTITIONER is a Nurse Practitioner in Phialdelphia, Pennsylvania. Qualified in 2020, 6 years ago. Practices with Eastern Pennsylvania Physician Alliance, LLC, a 110-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Pennsylvania.
- Years since qualifying
- 6
- Licensed in
- PA
- In the registry since
- 2020
Practice location Address checks out
1401 S 31 StPhialdelphia, PA 19146
Phone: (215) 925-2400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric/Mental Health Nurse Practitioner (primary) | Taxonomy 363LP0808X · Licence SP021594 (PA) |
|---|
Record details
| NPI number | 1407480155 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | NURSEPRACTITIONER |
| Sole proprietor | No |
| NPI enumerated | March 2, 2020 |
| Last updated in NPPES | September 11, 2023 |
| Certification date | September 11, 2023 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2020 (6 years in practice) |
| Group practice | Eastern Pennsylvania Physician Alliance, Llc — 110 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |
| Practice locations | 2 on file with Medicare |