Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Olawale Nurudeen Moyosore

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1063087849

Olawale Nurudeen Moyosore is a Psychiatric/Mental Health Nurse Practitioner in Prescott, Arizona. Licensed in Arizona and Texas. Registered with an NPI since 2021.

Licensed in
AZ, TX
In the registry since
2021
Specialties on file
2

Practice location Address checks out

500 Highway 89 N
Prescott, AZ 86313
Phone: (928) 445-4860
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 262277 (AZ)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence AP143491 (TX)

Record details

NPI number1063087849
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 24, 2021
Last updated in NPPESJanuary 28, 2022
Certification dateJanuary 28, 2022

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