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

Oluwatosin B Ajibola

Individual provider Family Nurse Practitioner · NPI 1063230464

Oluwatosin B Ajibola is a Nurse Practitioner in Grand Prairie, Texas. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in Texas.

Years since qualifying
2
Licensed in
TX
In the registry since
2024

Practice location Address checks out

4927 Lake Ridge Pkwy Ste 148
Grand Prairie, TX 75052-3000
Phone: (972) 217-4203
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1177043 (TX)

Record details

NPI number1063230464
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 3, 2024
Last updated in NPPESSeptember 4, 2025
Certification dateSeptember 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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